Document Detail

Traumatic fistula between the middle meningeal artery and the sphenoparietal sinus.
MedLine Citation:
PMID:  19468680     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Post-traumatic fistulas between the middle meningeal artery and the cranial venous system are extremely rare. We describe clinical presentation and successful endovascular management of a case of post-traumatic fistula between the middle meningeal artery and the sphenoparietal sinus.
METHODS: A 53-year-old man was admitted with multiple brain contusions and a temporoparietal fracture after a head trauma. On day 3 after trauma he developed unilateral signs of a cavernous sinus syndrome. Digital subtraction angiography showed a fistula between the middle meningeal artery and the sphenoparietal sinus.
RESULTS: The fistula was occluded by endovascular coil embolization, resulting in complete remission of the clinical symptoms.
CONCLUSION: A high index of suspicion is necessary to detect subtle signs of venous congestion of the cavernous sinus in an intubated patient. Angiography is the diagnostic modality of choice and should include the selective investigation of the external carotid artery vascular territory. Endovascular therapy provides minimal invasive and definitive treatment of this rare condition.
Claudia Unterhofer; Andreas Chemelli; Peter Waldenberger; Richard Bauer; Martin Ortler
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-05-26
Journal Detail:
Title:  Acta neurochirurgica     Volume:  151     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-13     Completed Date:  2010-01-25     Revised Date:  2011-04-29    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  1301-4     Citation Subset:  IM    
Clinical Department of Neurosurgery, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
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MeSH Terms
Accidents, Traffic
Arteriovenous Fistula / etiology*,  pathology,  radiography
Bicycling / injuries
Brain Injuries / complications,  pathology,  radiography
Cavernous Sinus Thrombosis / etiology,  physiopathology,  therapy
Cerebral Angiography
Cranial Sinuses / injuries*,  pathology,  radiography
Embolization, Therapeutic
Exophthalmos / etiology,  pathology,  physiopathology
Facial Bones / injuries
Head Injuries, Closed / complications*,  pathology,  radiography
Hematoma, Epidural, Cranial / pathology,  physiopathology,  radiography
Hematoma, Subdural / pathology,  physiopathology,  radiography
Intracranial Hypertension / etiology,  pathology,  radiography
Meningeal Arteries / injuries*,  pathology,  radiography
Middle Aged
Parietal Bone / injuries
Prostheses and Implants
Skull Fractures / complications*,  pathology,  radiography
Temporal Bone / injuries
Tomography, X-Ray Computed
Treatment Outcome
Vascular Surgical Procedures
Comment In:
Acta Neurochir (Wien). 2011 Apr;153(4):937   [PMID:  21052740 ]

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