RESUMEN
The blood supply to the region of the cavernous sinus is provided by interconnecting branches of the internal and external carotid arteries, and it is from these vessels that dural arteriovenous fistulas (DAVFs) arise. It is very rare that DAVFs are located at the intercavernous sinuses region; in this case, a proper localization of the fistulous site is of extreme importance in order to successfully eliminate the disease. Here, we describe a case of a 65-year-old female with intercavernous sinus DAVF. A complete obliteration of the fistulous points was performed by coil embolization through a transvenous approach.
RESUMEN
Many factors that determine the outcome of endovascular treatment of ruptured intracranial aneurysms are still controversial. We conducted a retrospective study of 203 patients with ruptured aneurysms treated by coiling to assess these factors. The Glasgow Outcome Scale score was used for clinical follow-up and magnetic resonance angiography for angiographic follow-up. Overall outcome and pretreatment variables predicting outcome were thoroughly analyzed. Good clinical grade on presentation was correlated with a better clinical outcome (p<0.001); however, symptomatic vasospasm (15.8% of patients) was correlated with a worse clinical outcome (p<0.001). Six patients (3%) suffered ischemic complications at the time of treatment, hemorrhagic events occurred in five patients (2.5%), permanent morbidity in five patients (2.5%) and overall mortality in 5.4%. In this series, we studied some factors currently debated in the literature and concluded that elderly patients (> or =65 years) with aneurysmal subarachnoid hemorrhage can safely be treated with endovascular therapy with a favorable outcome and that middle cerebral artery aneurysms can be safely embolized with results comparable to other locations.
