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Caroticocavernous fistula disease
Cavernous carotbolus artery detection is one of the diseases of the neuropathic specialties. Without timely diagnosis and treatment, this pathology will progress rapidly and severely affect the patient's vision. Nowadays, with the great progress of medicine, the problem of diagnosing this pathology has become easier and more accurate.1. Overview of Caroticocavernous fistula
Cavernous fistula artery detection is called Carotid - cavernous fistula, abbreviated as CCF. This pathology is occurring when there is an abnormal connection between the carotbolus and / or its branches and a large vein called a cave sinus. Cavernous sinuses are located behind the eyes and receive blood from the brain, eye sockets and the dorsal gland. A carotbolus fistula – cavernous sinus can be direct (high flow) or sedentous (indirect or low flow).
Cavernous carotbolus artery detection may occur due to injury or sedentous causes. CCF due to injury can occur after an injury in the head area, in which the artery in the inside is torn. Head wounds can go from mild falls to severe penetrating wounds. Trauma-in-part CCF can also be the result of endal interventions.
Natural cavernous carotbolus artery detection is usually the result of a ruptured carotbolus aneurysm. However, these fistulas can be congenital artery connections that open sedentously. This condition occurs against the background of collagen vascular disease, atherosclerosis, hypertension or childbirth.
2. Symptoms of cavernous carotose artery detection
2.1. Direct cavernous carotose artery detection
These clinical symptoms may appear immediately after the injury or a few days or weeks later. The typical trio of symptoms include: bulging eyes, conjunctivitis edema, hearing buzzing in the head. Other symptoms may include:
- Bulging eyes.
- Conjunctivitis of the eyes conjunctivitis, dilated conjunctivitis vessels.
- Usually conjunctivitis of lower lashes.
- Headache, eye socket pain.
- Decreased vision slowly or suddenly.
- Glaucoma due to increased upper vein pressure.
- There may be lash collapse, limited eye movement, double vision.
- The bottom of the eye: visual edema occurs, hemorrhages in the retina, retinal anemia.
For indirect cavernous carotose artery detection, clinical symptoms are often less intense than direct detection. The most common symptom is prolonged redness of the eyes. Next, vision decreases, and patients often complain that treatment in many places does not improve.
Since the symptoms are quite discreet and appear slowly, the majority of patients are often diagnosed and treated late. Therefore, eye complications caused by stagnation of intravenous veins may appear such as:
Second glaucoma due to increased upper vein pressure
Eye bottom: Edema and/or atrophy, retinal hemorrhage, central retinal vein occlusive.
3. Diagnosis
The diagnosis of cavernous carotose carotosis is firstly based on clinical symptoms as presented above. There are also a number of subclinical support for the determination of diagnosis including:
- Ultrasound of the arterial doppler – the eye vein shows the image of varicose veins of the eye. There is arterial communication, arterial veins, low RI. However, the results may be normal in case of carotbolus fistula – cavernous sinuses do not drain through the eye veins.
- CT – Scan of the brain: Shows images of varicose veins of the upper eye, hypertrophrosis of the external eye muscles, dilated cavernous sinuses and strong urethral infiltration.
- MRI: See similar signs on CT scan
- DSA scan: is the gold standard in the diagnosis of cavernous carotbolus artery detection.
Cavernous carotose artery detection can be treated with neurosurgery or endotheat techniques. The preferred technique is the endal method due to the lower rate of complications and death. However, not all CCFs can apply to both forms of treatment.
Treatment of cavernous carotose carotosis is insented when:
- Patients with severe eye symptoms, including: redness of the eyes, decreased vision, glaucoma, hemorrhage of retinal secretion.
- Patients with neurological symptoms associated with stagnation of cerebral veins such as: Increased headache, hepatic numbness, mental disorders.
- On brain imagery the pseudo-bulges are at high risk of fatal ruptures or massive nose and throat hemorrhages.
- Intravenous detectors on DSA images have cerebral aortic vein reflux that causes intracranial hemolysis.
Direct CCF has been treated in the traditional way by clogging the fistula with removable balls deployed through the skin. With the preservation of the inorent artery. Since removable balls are currently unavailable, other treatment options include placing a coating stent and rolling the fistula from a trans-arterial line with the support of a stent to preserve the inorent artery.
Indirect CCF can sometimes be self-cured but uncommon. Hand carnous artery compression can be done in low-risk CCF cases, since this method can cure almost 30% of fistulas. Indirect CCF can be treated by clogging the affected cavernous sinuses with coils, liquids or a combination of both.
4.2. Surgical treatment
CCF is surgically treated by removing part of the skull and then clogging the inorranial artery in the distance and near the fistula with surgical clips. Cavernous sinuses are then closed with acrylate, fascia, or Surgicel glue to clog the flow of veins. A branch of the outer veal artery may also have to be connected to the middle cerebral artery by a vein or artery depending on blood flow to the brain to prevent a stroke from occurring.
There is also a method of dropping muscles through the carotbolus opening to seal the probe hole or open the cavernous sinuses to stitch up the carotbolus tear hole. Surgical methods are generally dangerous, risky, so today are almost no longer carried out.
Source:
1. Michigan Medicine, "Carotid-Cavernous Fistula (CCF)"
Carotid-Cavernous Fistula (CCF) | Michigan Medicine
University of Michigan offers latest therapies for carotid-cavernous fistula (CCF,) an abnormal connection between carotid artery and/or cavernous sinus.
2. Bhatia, Kartik D; Wang, Lily, Richard J, Wenderoth, Jason D (2009). "Successful Treatment of Six Cases of Indirect Carotid-Cavernous Fistula with Ethylene Vinyl Alcohol Copolymer (Onyx) Transvenous Embolization", Journal of Neuro-Ophthalmology, 29 (1), pp. 3 – 8
3. Tran Chi Cuong (2012), Endotry interventional intervention study for post-traumatic cavernous carotose artery detection, Doctoral the these of medicine from The University of Medicine and Pharmacy of Ho Chi Minh City.
4. Nguyen Phan Tuong Vi, "Carotbolus artery detection – cave sinuses"
