Traumatic anterior communicating artery pseudoaneurysm with cavernous sinus fistula

Sakamoto Shigeyuki

Shibukawa Masaaki

Kiura Yoshihiro

Tsumura Ryu

Okazaki Takahito

Matsushige Toshinori

Kurisu Kaoru

Acta Neurochirurgica

A traumatic carotid-cavernous fistula and an intracranial pseudoaneurysm are uncommon but well-known complications of head trauma. A rare subtype of arteriovenous fistula may occur from a pseudoaneurysm of the anterior communicating artery (AcoA) instead of the internal carotid artery. We describe a patient with a traumatic pseudoaneurysm of the AcoA with a cavernous sinus fistula treated with endovascular treatment. A 68-year-old man presented with a severe head injury after a fall. Coronal view multiplanar reformatted images with contrast medium showed gradual expansion of the pseudoaneurysm of the AcoA and the enhanced area of the cavernous sinus. Five weeks after the injury, the patient had a subarachnoid hemorrhage. A cerebral angiogram showed a fistula between the pseudoaneurysm of the AcoA and the cavernous sinus. The AcoA, left anterior cerebral artery and part of the pseudoaneurysm were obliterated by coil embolization. A postoperative angiogram showed no flow through the pseudoaneurysm and the cavernous sinus fistula. A traumatic AcoA pseudoaneurysm with a cavernous sinus fistula may occur as an extremely rare complication of head injury.

Anterior communicating artery

Cavernous sinus

Endovascular treatment

Fistula

Pseudoaneurysm

Medical sciences [ 490 ]

eng

Springer Wien

Copyright (c) 2009 Springer

The original publication is available at www.springerlink.com

[ISSN] 0001-6268

[DOI] 10.1007/s00701-009-0285-6

[NCID] AA0050885X

[DOI] http://dx.doi.org/10.1007/s00701-009-0285-6