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Traumatic aneurysm of the supraclinoid internal carotid artery and an associated carotid-cavernous fistula: vascular reconstruction performed using intravascular implantation of stents and coils. Case report.

Abstract
This report documents the treatment of a traumatic aneurysm of the supraclinoid internal carotid artery (ICA) that was associated with a carotid-cavernous fistula (CCF), which appeared following closed head trauma. This life-threatening lesion, which is very rare, required aggressive management achieved using intravascular stents and coils. A 19-year-old man presented with severe traumatic intracerebral and subarachnoid hematoma after he had suffered a severe closed head injury in a motor vehicle accident. Cerebral angiography performed 11 days after the injury demonstrated a traumatic aneurysm and severe narrowing of the right supraclinoid ICA, which was consistent with a dissection-induced stenosis associated with a direct CCF. Both lesions were successfully obliterated with preservation of the parent artery by using stents in conjunction with coils. Follow-up angiography obtained 7 months postoperatively revealed persistent obliteration of the aneurysm and CCF as well as patency of the parent artery. The patient remained asymptomatic during the clinical follow-up period of 14 months. Endovascular treatment involving the use of a stent combined with coils appears to be a feasible, minimally invasive option for treatment of this hard-to-treat lesion.
AuthorsChang-Young Lee, Man-Bin Yim, Il-Man Kim, Eun-Ik Son, Dong-Won Kim
JournalJournal of neurosurgery (J Neurosurg) Vol. 100 Issue 1 Pg. 115-9 (Jan 2004) ISSN: 0022-3085 [Print] United States
PMID14743921 (Publication Type: Case Reports, Journal Article)
Topics
  • Adult
  • Carotid Artery Injuries (diagnostic imaging, surgery)
  • Carotid Artery, Internal (diagnostic imaging, surgery)
  • Carotid-Cavernous Sinus Fistula (diagnostic imaging, surgery)
  • Cerebral Angiography
  • Humans
  • Intracranial Aneurysm (diagnostic imaging, surgery)
  • Male
  • Plastic Surgery Procedures
  • Stents
  • Vascular Surgical Procedures

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