Carotid-cavernous sinus fistula with primary clinical manifestation of cerebral infarction: description of two cases

[摘要] Based on the nomenclature of Barrow, carotid-cavernousfistula (CCF) can be categorized into 4 types (types A–D) (1).Type A CCFs are direct, high-flow lesions connectingthe internal carotid artery (ICA) directly to the cavernoussinus. Type A CCFs often result from a single tear in thecarotid artery wall, caused either by trauma or aneurysmrupture. These are by far the most common type of CCFs,accounting for approximately 75–80% of CCFs overall.Types B, C, and D CCFs are all indirect, low-flow lesionsthat arise from meningeal branches of either the ICA orexternal carotid artery. Type B CCFs arise from meningealbranches of the ICA, type C CCFs arise from meningealbranches of the external carotid artery, and type D CCFsarise from meningeal branches of the ICA or externalcarotid artery. Posttraumatic CCFs are the most commontype, accounting for up to 75% of all CCFs. They have beenreported to occur in 0.2% of patients with craniocerebraltrauma and in up to 4% of patients who sustain a basilarskull fracture (2). Approximately 80% of patients with CCFhave ocular symptoms (3-6). We report 2 rare cases of CCFwithout ocular symptoms, mainly manifesting as cerebralinfarction.

[学科分类] 外科医学