Transvenous embolisation of a carotid-trigeminal cavernous fistula

YL Chan, KK Shing, KC Wong, WS Poon
Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong (now at the Magnus Magnetic Resonance and Ultrasound Diagnostic Centre, G3 and G3a, Mirror Tower, 61 Mody Road, Tsimshatsui, Hong Kong)

A carotid cavernous fistula is an abnormal communication between the internal carotid artery and the cavernous sinus. Rarely, this communication is associated with a persistent primitive trigeminal artery, with or without a trigeminal artery aneurysm. We report a case of spontaneous carotid-trigeminal cavernous fistula in which the persistent trigeminal artery was shown only on vertebral artery injection. The absence of an associated trigeminal artery aneurysm allowed a transvenous approach for endovascular treatment with coils and complete obliteration of the cavernous fistula.

Hong Kong Med J 2006;12:310-2

Key words: Carotid-cavernous sinus fistula; Embolization, therapeutic; Trigeminal nerve