{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T19:10:14Z","timestamp":1759173014323,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2017,10,19]]},"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:p>Direct carotid cavernous fistulae (CCF) are often detected early and treated promptly resulting in a paucity of literature regarding its long-term evolution. We present a case of high flow post-traumatic direct CCF that was neglected for over 6 years and presented with a rare manifestation of primary intraventricular haemorrhage. Occlusions of the primary venous outlets likely resulted in engorgement of the deep venous system. The segmental anatomy of the shunting basal vein is critical to the clinical presentation and may range from basal ganglia or brainstem oedema\/infarctions to uniquely, as in our case, isolated intraventricular haemorrhage secondary to variceal rupture. Treatment in such chronic cases requires a consideration of cerebral hyperperfusion syndrome necessitating deconstructive techniques with subsequent anticoagulation to avoid accelerated thrombosis of the venous varices.<\/jats:p>","DOI":"10.1136\/neurintsurg-2017-013396","type":"journal-article","created":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T17:25:27Z","timestamp":1575912327000},"page":"e3-e3","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Republished: Primary intraventricular haemorrhage due to rupture of giant varix of the basal vein of Rosenthal in a patient with long-standing direct CCF: angiographic features and treatment considerations"],"prefix":"10.1136","volume":"12","author":[{"given":"Chinmay P","family":"Nagesh","sequence":"first","affiliation":[{"name":"Imaging Sciences & Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aneesh","family":"Mohimen","sequence":"additional","affiliation":[{"name":"Imaging Sciences & Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santhosh K","family":"Kannath","sequence":"additional","affiliation":[{"name":"Imaging Sciences & Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayadevan E","family":"Rajan","sequence":"additional","affiliation":[{"name":"Imaging Sciences & Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,12,9]]},"reference":[{"key":"2025092911540837000_12.3.e3.1","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-006-0132-x"},{"key":"2025092911540837000_12.3.e3.2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.149.3.587"},{"key":"2025092911540837000_12.3.e3.3","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1985.62.2.0248"},{"key":"2025092911540837000_12.3.e3.4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/760267","article-title":"Venous drainage patterns in carotid cavernous fistulas","volume":"2014","author":"Aralasmak","year":"2014","journal-title":"ISRN Radiol"},{"key":"2025092911540837000_12.3.e3.5","doi-asserted-by":"publisher","DOI":"10.1007\/BF00593339"},{"key":"2025092911540837000_12.3.e3.6","first-page":"670","article-title":"Variations of the basal vein: identification using three-dimensional CT angiography","volume":"22","author":"Suzuki","year":"2001","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025092911540837000_12.3.e3.7","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3171\/2014.1.JNS132016","article-title":"Extensive basal ganglia edema caused by a traumatic carotid-cavernous fistula: a rare presentation related to a basal vein of Rosenthal anatomical variation","volume":"121","author":"Ract","year":"2014","journal-title":"J Neurosurg"},{"key":"2025092911540837000_12.3.e3.8","doi-asserted-by":"publisher","DOI":"10.15274\/INR-2014-10038"},{"key":"2025092911540837000_12.3.e3.9","doi-asserted-by":"crossref","first-page":"445","DOI":"10.3892\/etm.2015.2507","article-title":"Brainstem edema caused by traumatic carotid-cavernous fistula: a case report and review of the literature","volume":"10","author":"Yu","year":"2015","journal-title":"Exp Ther Med"},{"key":"2025092911540837000_12.3.e3.10","first-page":"751","article-title":"Normal perfusion pressure breakthrough occurring during treatment of carotid and vertebral fistulas","volume":"8","author":"Halbach","year":"1987","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025092911540837000_12.3.e3.11","doi-asserted-by":"publisher","DOI":"10.1177\/159101991001600213"},{"key":"2025092911540837000_12.3.e3.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-008-0468-5"},{"key":"2025092911540837000_12.3.e3.13","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-008-1278-1"},{"key":"2025092911540837000_12.3.e3.14","doi-asserted-by":"publisher","DOI":"10.15274\/INR-2014-10020"},{"key":"2025092911540837000_12.3.e3.15","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1177\/159101990200800310","article-title":"Treatment of trapped CCF by direct puncture of the cavernous sinus by Infraocular Trans-SOF approach. 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