J Korean Soc Radiol.  2017 May;76(5):322-325. 10.3348/jksr.2017.76.5.322.

A Traumatic Dural Arteriovenous Fistula between the Inferolateral Trunk of the Internal Carotid Artery and the Ophthalmic Vein: A Case of Transvenous Coil Embolization via the Facial Vein

• Kim J
• Kim DI
• Hong CK
• Suh SH

• KMID: 2377034
• DOI: http://doi.org/10.3348/jksr.2017.76.5.322

Abstract

A 31-year-old man was admitted with exophthalmos. He suffered from progressive exophthalmos, bruit and conjunctival chemosis 7 days after head trauma caused by falling down. Cerebral angiography showed a dural arteriovenous fistula (DAVF) draining into the ophthalmic vein caused by tear in the inferolateral trunk, which is a rare presentation of traumatic DAVF. Selective transvenous coil embolization was performed via the facial vein without neurologic complications.

MeSH Terms

Accidental Falls
Adult
Carotid Artery, Internal*
Central Nervous System Vascular Malformations*
Cerebral Angiography
Craniocerebral Trauma
Embolization, Therapeutic*
Exophthalmos
Humans
Tears
Veins*

Figure

• 

  Fig. 1 A dural arteriovenous fistula of the ophthalmic vein caused by traumatic injury of the inferolateral trunk in a 31-year-old male who presented with exophthalmos. A. The right ICA angiography showed a fistulous point between the right ILT and confluence of right ophthalmic veins. B. The right ECA angiography showed a dural arteriovenous fistula with multiple dural feeders from the right MMA, artery of foramen rotundum of the internal maxillary artery, which formed a common fistulous point draining directly into the confluence of right ophthalmic veins. C. Through the right facial vein and the SOV, a microcatheter was navigated distal to the fistulous point and embolization was performed using a detachable coil (2 × 5 mm). D. The right ICA angiography performed immediately the after procedure showed complete obliteration of the dural arteriovenous fistula between the ophthalmic vein and the inferolateral trunk. ECA = external carotid artery, ICA = internal carotid artery, MMA = middle meningeal artery, SOV = superior ophthalmic vein

• 

  Fig. 2 Diagram of the dural arteriovenous fistula. Multiple feeders from the right MMA, artery of foramen rotundum of the internal maxillary artery formed a common fistulous point draining directly into the confluence of right ophthalmic veins. ICA = internal carotid artery, MMA = middle meningeal artery, SOV = superior ophthalmic vein

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