J Korean Neurosurg Soc.  2011 Apr;49(4):226-228. 10.3340/jkns.2011.49.4.226.

Direct Carotid Cavernous Fistula of an Adult-Type Persistent Primitive Trigeminal Artery with Multiple Vascular Variations

• Jin SC
• Park H
• Kwon DH
• Choi CG

• KMID: 1442592
• DOI: http://doi.org/10.3340/jkns.2011.49.4.226

Abstract

We report a case of spontaneous right carotid-cavernous fistula (CCF) in a proximal segment of persistent primitive trigeminal artery (PPTA) and combined vascular anomalies such as left duplicated hypoplastic proximal posterior cerebral arteries and a variation of anterior choroidal artery supplying temporal and occipital lobe. A 45-year-old male presented with progressive right exophthalmos, diplopia, and ocular pain. With manual compression of the internal carotid artery, a cerebral angiography revealed a right CCF from a PPTA. Treatment involved the placement of detachable non-fibered and fibered coils, and use of a hyperglide balloon to protect against coil herniation into the internal carotid artery. A final angiograph revealed complete occlusion of PPTA resulted in no contrast filling of CCF.

Keyword

Persistent primitive trigeminal artery; Carotid cavernous fistula; Duplicated posterior cerebral artery

MeSH Terms

Arteries
Carotid Artery, Internal
Caves
Cerebral Angiography
Choroid
Diplopia
Exophthalmos
Fistula
Humans
Male
Middle Aged
Occipital Lobe
Posterior Cerebral Artery