Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
9880253 | Journal of the Neurological Sciences | 2005 | 4 Pages |
Abstract
A 55-year-old woman developed an intractable right orbitofrontal headache. The symptoms subsided spontaneously 2 months after onset, but diplopia due to right abducens nerve palsy had occurred, and gradually worsened. Orbito-ocular signs were never observed throughout the clinical course. Brain MRI and MR angiography demonstrated abnormal signal changes corresponding to the right cavernous sinus. Angiography confirmed a dural carotid-cavernous sinus fistula (CCF) with three directional drainage routes in the arterial phase. Although the most prominent draining vein was the superior ophthalmic vein (SOV), an outflow with a high flow rate into the angular facial vein prevented prolonged enhancement of the SOV in the venous phase. These findings suggest that the absence of orbito-ocular signs in dural CCF with an anterior venous drainage could be attributed to the relief of venous hypertension of the SOV.
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Authors
Kazuyo Ikeda, Kazushi Deguchi, Masago Tsukaguchi, Iwao Sasaki, Mieko Shimamura, Yoshiteru Urai, Tetsuo Touge, Masahiko Kawanishi, Hiroaki Takeuchi, Shigeki Kuriyama,