Painful fourth cranial nerve palsy caused by posteriorly-draining dural carotid-cavernous sinus fistula.
نویسندگان
چکیده
A 65-year-old man with a dural carotid-cavernous fistula (DCCF) presented with sudden onset of painful trochlear nerve paresis. Typical signs of DCCF including conjunctival arterialization, chemosis, and proptosis did not become manifest until 4 months later. This unusual presentation of DCCF was caused by drainage of the fistula posteriorly into the inferior petrosal sinus with low flow. With this condition, patients may present with trochlear nerve palsy without a red eye. Although rare, DCCF must be considered in patients presenting with isolated painful trochlear palsy.
منابع مشابه
Dural Arteriovenous Fistulas in the Cavernous Sinus: Clinical Research and Treatment
Introduction. The purpose of this paper is to clarify the clinical course, with the dural carotid cavernous fistula (CCF), featuring a pallet of symptoms, paying special attention to radiological findings. Methods. Seventy-six consecutive patients with dural CCFs were investigated in detail, all of whom were defined by angiography. Results. The most common initial symptom was diplopia in 47 pat...
متن کاملPosterior-draining dural carotid cavernous fistulae: a possible cause of computed tomographic angiography negative isolated third nerve palsy
Computed tomographic angiography (CTA) is a well-established non-invasive investigation for this neurological presentation to exclude intracranial aneurysms. However, dural arteriovenous fistulae with anterograde venous drainage only can be missed by CTA. Here we reported two patients with painful complete third nerve palsy and dural carotid cavernous fistulae with anterograde venous drainage o...
متن کاملSpontaneous carotid-cavernous fistula with ophthalmoplegia and facial palsy.
Spontaneous carotid-cavernous fistulae are uncommon. They are seen mostly in association with hypertension, atherosclerosis or intracranial aneurysm (Bickerstaff, 1970). Facial palsy was noted by Walsh (1957) in a case of traumatic carotid-cavernous fistula which recovered in one year. Involvement of the third, fourth, fifth and sixth cranial nerves has been frequently noted (Walsh, 1957; Sattl...
متن کاملSurgical transvenous embolization of a cortically draining carotid cavernous fistula via a vein of the sylvian fissure.
Percutaneous transvenous embolization is one of the most effective treatments of intracranial dural arteriovenous fistulas (AVFs) involving the dural sinuses. We present a unique case of surgical transvenous embolization in a 48-year-old man with a dural AVF of the cavernous sinus who presented with intracerebral hematoma. The dural AVF drained only into the vein of the sylvian fissure on angio...
متن کاملSpontaneous Carotid Cavernous Fistula in a Case with Protein S Deficiency that Newly Developed Ophthalmoplegia after Embolization
BACKGROUND Carotid cavernous fistula (CCF) is an abnormal communication between the carotid artery and the cavernous sinus. The pathogenesis of spontaneous CCF remains unclear, although sinus thrombosis is known to be a predisposing factor for dural arteriovenous fistula. Because spontaneous CCFs are mainly of the dural type, we considered that thrombogenic conditions, such as, protein S defici...
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ورودعنوان ژورنال:
- Journal of the Formosan Medical Association = Taiwan yi zhi
دوره 99 9 شماره
صفحات -
تاریخ انتشار 2000