A case of traumatic anterior cerebral artery-cavernous sinus fistula

Tran Anh Tuan; Nguyen Van Tuan; Le Nguyen Quyen; Nguyen Tat Thien

doi:10.1016/j.radcr.2020.11.012

A case of traumatic anterior cerebral artery-cavernous sinus fistula

Radiol Case Rep. 2020 Nov 16;16(1):185-191. doi: 10.1016/j.radcr.2020.11.012. eCollection 2021 Jan.

Authors

Tran Anh Tuan^{1

2}, Nguyen Van Tuan³, Le Nguyen Quyen⁴, Nguyen Tat Thien²

Affiliations

¹ Radiology Department, Hanoi Medical University, Ha Noi, Vietnam.
² Radiology Center, Bach Mai Hospital, Ha Noi, Vietnam.
³ Neurology Department, Bach Mai Hospital, Ha Noi, Vietnam.
⁴ Department of Thoracic, Vascular and Neurology, Trung Vuong Hospital, Ho Chi Minh city, Vietnam.

Abstract

Direct anterior cerebral artery-cavernous sinus fistula is an extremely rare complication of head trauma. We describe a male patient (age 49 years) with a history of head trauma 15 years ago who was hospitalised for a bulging red eye and tinnitus. Digital subtraction angiography showed a direct anterior cerebral artery (fork junction A1 - prior passage)-cavernous sinus fistula. The patient was treated with arterial endovascular intervention, complete sealing of the fistula orifice using coils. He was discharged 5 days later with no symptoms of a bulging red eye, ringing in the ears, or nerve paralysis. Re-examination after 3 months of stable clinical features did not show recurrent fistula. In conclusion, anterior cerebral artery-cavernous sinus fistula is an extremely rare lesion, and arterial endovascular intervention using coils is a safe and effective method for treatment of such lesion.

Keywords: ACA, anterior cerebral artery; AcoA, Anterior communicating artery; CCF, carotid cavernous fistula; Cavernous Sinus; Cerebral Artery; DSA, digital subtraction angiography; Fistula; Trauma.

Publication types

Case Reports