Endoscopic endonasal transsphenoidal direct access and Onyx embolization of a dural arteriovenous fistula mimicking a carotid-cavernous fistula: Case report

Patrick J. Karas, Robert Y. North, Visish M. Srinivasan, Nathan R. Lindquist, K. Kelly Gallagher, Jan Karl Burkhardt, Daniel Yoshor, Peter Kan

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

The classic presentation of a carotid-cavernous fistula (CCF) is unilateral painful proptosis, chemosis, and vision loss. Just as the goal of treatment for a dural arteriovenous fistula (dAVF) is obliteration of the entire fistulous connection and the proximal draining vein, the modern treatment of CCF is endovascular occlusion of the cavernous sinus via a transvenous or transarterial route. Here, the authors present the case of a woman with a paracavernous dAVF mimicking the clinical and radiographic presentation of a CCF. Without any endovascular route available to access the fistulous connection and venous drainage, the authors devised a novel direct hybrid approach by performing an endoscopic endonasal transsphenoidal direct puncture and Onyx embolization of the fistula. https://thejns.org/doi/abs/10.3171/2020.7.JNS201737.

Original languageEnglish (US)
Pages (from-to)722-726
Number of pages5
JournalJournal of neurosurgery
Volume135
Issue number3
DOIs
StatePublished - Sep 2021
Externally publishedYes

Keywords

  • Carotid-cavernous malformation mimic
  • Dural arteriovenous fistula
  • Endoscopic endonasal transsphenoidal
  • Percutaneous embolization
  • Vascular disorders

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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