View abstract

This abstract is assigned to session OB Poster session > in O'Bistro

Title

Atypical dural carotid cavernous sinus fistula presenting as direct carotid cavernous sinus fistula

Purpose	To report a case of spontaneous dural carotid cavernous sinus fistula (CCSF) with symptoms and signs similar to traumatic direct CCSF fistula.
Methods	Case report
Results	CCSF are abnormal communications between the carotid arterial system and the venous cavernous sinus. Most often they are classified as either direct o indirect (also named dural). Clinical manifestations of CCSF frequently involve ophthalmic abnormalities. Direct CCSF results from a direct connection between the intracavernous carotid artery and the cavernous sinus, while dural CCSF arises from abnormal shunts to the cavernous sinus from the meningeal branches of the carotid artery. Typically, signs and symptoms of direct fistulas have an acute onset and dramatic ophthalmologic consequences, while dural fistulas have a gradual onset and milder ophthalmologic consequences. Our patient had acute and severe symptoms. Unexpectedly, the arteriography diagnosed a dural CCSF. It also revealed a recent homolateral petrous sinus thrombosis that possibly prevented further posterior drainage of the fistula, precipitating anteriorly redirected high flow and favouring an acute and dramatic clinical onset.
Conclusion	Dural CCSF may have an acute onset and present signs and symptoms as severe as in direct CCSF if a local thrombotic event abruptly modifies its blood drainage.

Author 1

Last name	ATTHA
Initials	E
Department	CUB hôpital Erasme
City	Brussels

Author 2

Last name	Lubicz
Initials	B
Department	CUB hôpital Erasme
City	Brussels

Author 3

Last name	Janssens
Initials	S
Department	CHU hôpital St Pierre
City	Brussels

Author 4

Last name	Cordonnier
Initials	M
Department	CUB hôpital Erasme
City	Brussels