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Carotid Cavernous Fistula and ICA Aneurysm

Theeler BJT - MedPix

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Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Carotid Cavernous Fistula and ICA Aneurysm

History: 20 y/o male inside HUM-V when hit with an RPG (rocket propelled grenade).

Findings: CT with contrast shows an enlarged R parasellar region consistent with an ICA aneurysm, and abnormal vasculature filling with contrast in the R posterior fossa. The R Carotid angiogram shows a large, cavernous ICA aneurysm. The angiogram also shows that this aneurysm is draining into the cavernous sinus. The R superior opthalmic vein is engorged, and visible in the arterial phase. The carotid cavernous fistula is also draining posteriorly into the transverse and sigmoid sinuses (likely through the superior petrosal and inferior petrosal sinuses)which are also visible in the arterial phase of the angiogram.

Ddx: Trauma

Dxhow: Angiographic

No MeSH data available.


On this image notice the R parasellar area is enlarged and filled with contrast.  A subtle finding on this film is a small vein making a loop in the region of Dorello\'s canal.  Hmm...what might be a finding on this patient\'s cranial nerve exam?
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MPX1941_synpic24521: On this image notice the R parasellar area is enlarged and filled with contrast. A subtle finding on this film is a small vein making a loop in the region of Dorello\'s canal. Hmm...what might be a finding on this patient\'s cranial nerve exam?


Carotid Cavernous Fistula and ICA Aneurysm

Theeler BJT - MedPix

On this image notice the R parasellar area is enlarged and filled with contrast.  A subtle finding on this film is a small vein making a loop in the region of Dorello\'s canal.  Hmm...what might be a finding on this patient\'s cranial nerve exam?
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1941&req=5

MPX1941_synpic24521: On this image notice the R parasellar area is enlarged and filled with contrast. A subtle finding on this film is a small vein making a loop in the region of Dorello\'s canal. Hmm...what might be a finding on this patient\'s cranial nerve exam?

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Carotid Cavernous Fistula and ICA Aneurysm

History: 20 y/o male inside HUM-V when hit with an RPG (rocket propelled grenade).

Findings: CT with contrast shows an enlarged R parasellar region consistent with an ICA aneurysm, and abnormal vasculature filling with contrast in the R posterior fossa. The R Carotid angiogram shows a large, cavernous ICA aneurysm. The angiogram also shows that this aneurysm is draining into the cavernous sinus. The R superior opthalmic vein is engorged, and visible in the arterial phase. The carotid cavernous fistula is also draining posteriorly into the transverse and sigmoid sinuses (likely through the superior petrosal and inferior petrosal sinuses)which are also visible in the arterial phase of the angiogram.

Ddx: Trauma

Dxhow: Angiographic

No MeSH data available.