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Year : 2018  |  Volume : 13  |  Issue : 4  |  Page : 1244-1246

Coil embolisation of post traumatic giant supraclinoid pseudoaneurysm presenting as carotid cavernous fistula

1 Department of Neurosurgery, KEM Hospital, Lilavati Hospital, Mumbai, Maharashtra, India
2 Department of Neurosurgery, Lilavati Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Dange Nitin Narayan
Department of Neurosurgery, KEM Hospital, Lilavati Hospital, Mumbai, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_161_17

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This report documents the occurrence, diagnosis and treatment of a 29 year-old male patient who presented with progressive swelling of the left eye with associated progressive loss of vision, three months after sustaining a closed head injury in a road traffic accident. Magnetic resonance imaging (MRI) showed a large, ill-defined lesion in the left supraclinoid and paraclinoid region with variable contrast enhancement. A four vessel Digital Subtraction Angiography (DSA) showed a large, supra-clinoid pseudoaneurysm which had ruptured inferiorly into the roof of cavernous sinus, forming direct carotid cavernous fistula (CCF) which lead to dilatation of the superior ophthalmic vein and subsequent peri-orbital oedema and chemosis of conjunctiva. Complete obliteration of the indirect CCF was achieved by coiling of the aneurysm alone. During follow up, patient reported a significant improvement in vision and follow up DSA after one year shows no recurrence with this technique.

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