Dural Cavernous Sinus Fistulas: Diagnosis and Endovascular by Goetz Benndorf

By Goetz Benndorf

Dural cavernous sinus fistulas (DCSFs) are benign vascular illnesses consisting in an arteriovenous shunt on the cavernous sinus that if misdiagnosed may end up in most likely critical ophthalmologic problems. This quantity presents a whole advisor to the prognosis and minimum invasive therapy of DCSFs. After sections on anatomy and class, etiology and pathogenesis of DCSFs, the symptomatology of the ailment is defined intimately. The position of contemporary imaging suggestions within the analysis of DCSFs is then addressed. electronic subtraction angiography (DSA) is still the top of the line for scientific decision-making; right here, complete attention is given to either, traditional second DSA and rotational 3D angiography. contemporary technological advances during this box comparable to twin quantity (DV) imaging and angiographic computed tomography (ACT) are regarded as good. Due realization is extra paid to using computed tomography, magnetic resonance imaging and ultrasound. eventually, the healing administration of DCSFs with emphasis on quite a few transvenous occlusion recommendations are mentioned extensive. This well-illustrated quantity can be beneficial to all who might come across DCSF of their scientific perform.

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Extra info for Dural Cavernous Sinus Fistulas: Diagnosis and Endovascular Therapy (Medical Radiology Diagnostic Imaging)

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The artery begins at the bifurcation of the common carotid artery (CCA), usually at the level of the fourth cervical vertebra, where it is enlarged to form the so-called carotid sinus. Fischer (1938) divided the ICA into four segments: the cervical, the petrous, the cavernous and the cerebral segment (Fig. 5). The cervical segment extends almost vertically to the base of the skull to reach the Apertura externa (external aperture) of the Canalis caroticus (carotid canal) to enter the petrous bone.

1978a) which can arise from a common trunk with medial tentorial artery (Martins et al. 2005). ¼ A medial clival artery has been described by Lasjaunias et al. (2001) and Martins et al. (2005) (see above). It should be mentioned that Pribram et al. (1966) have already emphasized that the classic MHT arising as a single trunk is not constantly seen. The existence of a singular trunk was observed by Lasjaunias et al. (1978a) in only 10% of the cases. He suggested instead that these branches more often arise independently as single vessels corresponding to the remnants of two transient embryonic vessels, the primitive maxillary and the primitive trigeminal artery.

The latter erroneously described these branches as all passing through the supraorbital fissure and did not recognize the artery of the foramen rotundum. Although neglected in several textbooks, modern high-resolution DSA and, in particular, 3D-DSA reveal that in some DCSFs these “Aa. anastomoticae”, passing through the SOF, are indeed identifiable. They course more cranially above the artery of the foramen rotundum and often contribute to the supply of DCSFs (see Chap. 7). 3 Middle Meningeal Artery The middle meningeal artery (MMA) is the second ascending branch of the IMA and the largest of the dural arteries.

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