AJDRAJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 2007;28:1915.

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A0717

CASE REPORT

Marginal Sinus Arteriovenous Fistulas Mimicking Carotid Cavernous Fistulas: Diagnostic and Therapeutic Considerations

R.D. Turner, V. Gonugunta, M.E. Kelly, T.J. Masaryk and D.J. Fiorella

From the Departments of Neurosurgery and Neuroradiology, Cleveland Clinic, Cleveland, Ohio.

Please address correspondence to R. Turner, MD, Department of Neurological Surgery, Cleveland Clinic Foundation, 9500 Euclid Ave, S80, Cleveland, OH 44195; e-mail: turnerr{at}ccf.org

SUMMARY: Marginal sinus fistulas (MSFs) are uncommon vascular anomalies. Occasionally, the dominant venous drainage is forced retrograde up the inferior petrosal sinus and into the cavernous sinus, causing chemosis, proptosis, and ocular hypertension, mimicking a carotid cavernous fistula. This atypical clinical presentation may lead to misdiagnosis and inappropriate hazardous treatment of an MSF. Identifying the site of the fistula and understanding the anatomy of the venous drainage are critical in providing appropriate, safe, and efficacious endovascular treatment.






Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X