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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 22:537-540 (3 2001)
© 2001 American Society of Neuroradiology

ARTICLE

Transsphenoidal Computer-navigation–assisted Deflation of a Balloon after Endovascular Occlusion of a Direct Carotid Cavernous Sinus Fistula

Joachim Klisch^,a, Jörg Schipper^a, Hartmut Husstedt^a, Roland Laszig^a and Martin Schumacher^a

^a From the Departments of Neurosurgery, Section of Neuroradiology (J.K., H.H., M.S.) and Otolaryngology and Head and Neck (J.S., R.L.), University of Freiburg, Freiburg, Germany.

Summary: A 49-year-old woman with a direct posttraumatic carotid cavernous fistula (CCF) was treated with detachable balloons via a transcarotid route. After the procedure, her intracranial bruit, conjunctival injection, and orbital congestion were cured, but the preexistent sixth nerve palsy deteriorated.

CT showed one balloon positioned in the posterior portion of the right cavernous sinus and was regarded to be responsible for nerve compression. After surgical exposure by use of a transnasal-transsphenoidal approach under 3D navigation control, this balloon was deflated by puncture with a 22-gauge needle.

The previously described symptoms resolved after balloon deflation. This report presents a rare complication of endovascular treatment of direct CCF and a new microsurgical approach to a balloon in a case of nerve compression.

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