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Journal of Neurosonology 2016;8(2):45-48.
Dural Carotid Cavernous Fistula Treated by Manual Carotid Compression Guiding with Transcranial Doppler
초음파유도하 경부동정맥혈관 압박법에 의해 치료된 경질막목동맥해면정맥동루 1예
A 86-year old woman was presented with sudden left side weakness and diplopia. Brain magnetic resonance image showed acute lesions in the right middle cerebral artery territory. In T2 weighted image, dilatations of left superior ophthalmic vein and cavernous sinus were detected. Digital subtraction angiography revealed left dural carotid cavernous fistula classified as Barrow type D. Instead of embolization of the fistula, a manual compression of carotid artery and jugular vein was applied by guiding with transcranial Doppler (TCD). After 4 months, superior ophthalmic venous flow was disappeared and left eye gaze palsy was resolved. TCD guided carotid manual compression can be easily and safely applied to patient with dural carotid cavernous fistula.
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