Traumatic carotid‑cavernous fistula with perimedullary venous drainage and delayed myelopathy: A case report

Ding,Chun-Long; Zhang,Chun-Lei; Hua,Feng; Xi,Shao-Dong; Zhou,Qin-Wei; Wang,Hui-Jun; Chen,Jun-Jie; Qiu,Jie

doi:10.3892/mi.2021.16

November-December 2021 Volume 1 Issue 5

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November-December 2021 Volume 1 Issue 5

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Case Report Open Access

Traumatic carotid‑cavernous fistula with perimedullary venous drainage and delayed myelopathy: A case report

Authors:
- Chun-Long Ding
- Chun-Lei Zhang
- Feng Hua
- Shao-Dong Xi
- Qin-Wei Zhou
- Hui-Jun Wang
- Jun-Jie Chen
- Jie Qiu
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Affiliations: Department of Neurosurgery, Xishan People's Hospital, Wuxi, Jiangsu 214000, P.R. China, Department of Neurosurgery, 904th Hospital of Chinese People's Liberation Army Joint Logistic Support, Wuxi, Jiangsu 214000, P.R. China

Copyright: © Ding et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Article Number: 16
|
Published online on: September 17, 2021

https://doi.org/10.3892/mi.2021.16
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Abstract

Traumatic carotid‑cavernous fistula (TCCF) with perimedullary venous drainage and delayed myelopathy is a relatively rare clinical lesion. Endovascular embolization using embolic agents is the preferred treatment for patients with a poor collateral circulation. The present study describes the case of a 45‑year‑old male with TCCF, who presented with progressive cervical myelopathy for 1 month. A previous history of the patient included an anterior skull base fracture induced by a traffic accident 2 years prior. Cervical spinal magnetic resonance imaging (MRI) revealed dilated perimedullary veins and cervical spinal cord edema. Cerebral digital subtraction angiography revealed a direct CCF with perimedullary venous drainage. The patient received endovascular treatment with coils and an Onyx liquid embolic system to occlude the fistula, and his symptoms were relieved when he was discharged 3 weeks later. The patient then felt normal and a cervical spinal MRI revealed the disappearance of the perimedullary veins dilation and spinal cord edema at the 6‑month follow‑up. To the best of our knowledge, only three cases of CCFs with perimedullary venous drainage presenting with myelopathy have been previously reported. The present study also discussed the possible pathological mechanisms for this rare presentation. Moreover, it is suggested that the possibility of CCFs as a cause of cervical myelopathy needs to be taken into consideration.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Traumatic carotid‑cavernous fistula with perimedullary venous drainage and delayed myelopathy: A case report

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