Dural Cavernous Sinus Fistulas Diagnostic and Endovascular Therapy
Dural cavernous sinus fistulas (DCSFs) represent a benign vascular disease, consisting in an arteriovenous shunt at the cavernous sinus. In the absence of spontaneous resolution, the fistula may lead to eye redness, swelling, proptosis, chemosis, ophthalm
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MEDICAL RADIOLOGY
Diagnostic Imaging Editors: A. L. Baert, Leuven M. Knauth, Göttingen K. Sartor, Heidelberg
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Goetz Benndorf
Dural Cavernous Sinus Fistulas Diagnostic and Endovascular Therapy Foreword by
K. Sartor With 178 Figures in 755 Separate Illustrations, 540 in Color and 19 Tables
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Goetz Benndorf, MD, PhD Associate Professor, Department of Radiology Baylor College of Medicine Director of Interventional Neuroradiology Ben Taub General Hospital One Baylor Plaza, MS 360 Houston, TX 77030 USA
Medical Radiology · Diagnostic Imaging and Radiation Oncology Series Editors: A. L. Baert · L. W. Brady · H.-P. Heilmann · M. Knauth · M. Molls · C. Nieder · K. Sartor Continuation of Handbuch der medizinischen Radiologie Encyclopedia of Medical Radiology
ISBN 978-3-540-00818-7
e-ISBN 978-3-540-68889-1
DOI 10.0007 / 978-3-540-68889-1 Medical Radiology · Diagnostic Imaging and Radiation Oncology ISSN 0942-5373 Library of Congress Control Number: 2004116221 © 2010, Springer-Verlag Berlin Heidelberg This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitations, broadcasting, reproduction on microfi lm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law. The use of general descriptive names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Cover-Design and Layout: PublishingServices Teichmann, 69256 Mauer, Germany Printed on acid-free paper – 21/3180xq 9876543210 springer.com
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Dedicated to my parents,
Dorothea and Eberhard Benndorf
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Foreword
Of the dural venous sinuses, the cavernous sinus is anatomically the most complex. It has an intimate topographical relationship with the internal carotid artery and the sixth cranial nerve (both of which pass through its meshwork) and houses the cranial nerves III, IV and V1-2 in its lateral wall. Medially it abuts the pituitary gland, while laterally it nears the temporal lobe; Meckel’s cave with the trigeminal ganglion lies immediately posterior to it. Located essentially at the center of the skull base, the cavernous sinus connects with numerous dural sinuses and veins of all three cranial fossae, as well as the orbit. Furthermore, there is an abundance of dural arteries in the sellar region that
