Traumatic aneurysm of the supraclinoid internal carotid artery and an associated carotid—cavernous fistula: vascular reconstruction performed using intravascular implantation of stents and coils

• DOI: 10.3171/jns.2004.100.1.0115
• Publication Date: 2009-05-13T18:00:25Z
• Authors: Chang-Young Lee; Man-Bin Yim; Il-Man Kim; Eun-Ik Son; Dong-Won Kim
• Keywords: Adult; Male; Intracranial Aneurysm; Plastic Surgery Procedures; Cerebral Angiography; 3. Good health; 03 medical and health sciences; Carotid-Cavernous Sinus Fistula; 0302 clinical medicine; Humans; Stents; Carotid Artery Injuries; Vascular Surgical Procedures; Carotid Artery, Internal

✓ This report documents the treatment of a traumatic aneurysm of the supraclinoid internal carotid artery (ICA) that was associated with a carotid—cavernous fistula (CCF), which appeared following closed head trauma. This life-threatening lesion, which is very rare, required aggressive management achieved using intravascular stents and coils. A 19-year-old man presented with severe traumatic intracerebral and subarachnoid hematoma after he had suffered a severe closed head injury in a motor vehicle accident. Cerebral angiography performed 11 days after the injury demonstrated a traumatic aneurysm and severe narrowing of the right supraclinoid ICA, which was consistent with a dissection-induced stenosis associated with a direct CCF. Both lesions were successfully obliterated with preservation of the parent artery by using stents in conjunction with coils. Follow-up angiography obtained 7 months postoperatively revealed persistent obliteration of the aneurysm and CCF as well as patency of the parent artery. The patient remained asymptomatic during the clinical follow-up period of 14 months. Endovascular treatment involving the use of a stent combined with coils appears to be a feasible, minimally invasive option for treatment of this hard-to-treat lesion.