By Goetz Benndorf MD, PhD (auth.)
Dural cavernous sinus fistulas (DCSFs) characterize a benign vascular disorder, consisting in an arteriovenous shunt on the cavernous sinus. within the absence of spontaneous answer, the fistula could lead on to eye redness, swelling, proptosis, chemosis, ophthalmoplegia and visible loss. even if glossy imaging strategies have more desirable the diagnostic, sufferers with low-flow DCSFs are nonetheless misdiagnosed. those sufferers can get erroneously handled for infections and irritation for months or years and are liable to visible loss. Early and correct prognosis is helping to prevent deleterious medical process the affliction. This quantity offers a whole consultant to scientific and radiological analysis in addition to to healing administration of DCSF with emphasis on sleek minimum invasive healing procedures. It commences with an informative description of suitable anatomy. After sections at the class, etiology and pathogenesis of DCSF, the scientific symptomatology of the sickness is defined intimately. The position of recent non-invasive imaging instruments is then addressed with using computed tomography, magnetic resonance imaging and ultrasound. Intra-arterial electronic subtraction angiography (DSA), even though invasive, is still the ideal and is crucial for scientific decision-making and technique in endovascular remedy. accordingly, a all through attention is given to either, 2D-DSA and 3D rotational angiography, together with fresh technological developments corresponding to twin quantity (DV) imaging and angiographic computed tomography (ACT). After a quick part on arteriovenous hemodynamics, the healing administration of DCSFs is defined intimately. specifically, quite a few transvenous recommendations, required for winning endovascular occlusion of DCSF, are mentioned intensive. This well-illustrated quantity might be helpful to all who may possibly stumble upon DCSF of their scientific practice.
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Additional info for Dural Cavernous Sinus Fistulas: Diagnostic and Endovascular Therapy
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.
2 External Carotid Artery The external carotid artery (ECA) gives off four major arteries, the branches of which contribute to the supply of the CS and the CNs. 1 Ascending Pharyngeal Artery The ascending pharyngeal artery (APA), the smallest branch of the ECA, is a rather gracil, long vessel. It arises close to the origin of the ECA at its dorsal circumference and ascends between ICA and the pharyngeal wall to reach the base of the skull. Its meningeal branches are very small vessels, supplying the dura mater and have been described in detail by Lasjaunias and Moret (1976).
The long posterior ciliary arteries supply the internal structure of the anterior portion of the eye (Ducasse et al. 1986). Important anastomoses are formed by the anterior and posterior ethmoidal arteries, the lacrimal artery and the deep and superﬁcial recurrent ophthalmic arteries. The deep recurrent ophthalmic artery usually arises from the ﬁ rst part of the intraorbital OA, courses backwards through the SOF and consistently anastomoses with the anteromedial ramus of the ILT. The angiographic appearance of this vessel is characteristic when it projects below the C3 and C4 portion of the ICA (Lasjaunias et al.