Journal
JOURNAL OF CLINICAL ULTRASOUND
Volume 31, Issue 6, Pages 319-323Publisher
JOHN WILEY & SONS INC
DOI: 10.1002/jcu.10175
Keywords
duplex Doppler ultrasonography; carotid cavernous sinus fistula; head trauma
Ask authors/readers for more resources
Duplex sonography used as a primary diagnostic tool in the case of a 17-year-old boy with a traumatic head injury revealed bilateral carotid cavernous sinus fistulas, with bilateral dilated venous convolutions next to the carotid siphon and dilated superior ophthalmic veins. A bilateral craniectomy allowed visualization of the entire circle of Willis together with the dilated cavernous sinuses. Doppler spectral analysis of blood flow in the arterialized superior ophthalmic veins revealed an arterialized venous pattern with retrograde and increased blood flow. The same blood flow profile was found in the venous cavernous sinuses. These findings were confirmed by digital subtraction angiography. We planned to perform embolization of the patient's fistulas, but intracranial and subarachnoid hemorrhaging developed, and the patient died the day before the procedure was to have been performed. The entire pathologic state of carotid cavernous sinus fistulas, from their origin beside the carotid siphon to the superior ophthalmic veins, can be visualized with duplex sonography, particularly when patients have undergone craniectomy. We believe that patients with frontal or basilar skull fracture should undergo duplex sonographic examination to detect carotid cavernous sinus fistulas. (C) 2003 Wiley Periodicals, Inc.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available