{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:45:44Z","timestamp":1770115544184,"version":"3.49.0"},"reference-count":66,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,1,27]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Direct carotid-cavernous fistulas (CCFs) are relatively rare but dangerous complications of penetrating traumatic brain injury or maxillofacial trauma. A variety of clinical signs have been described, including ophthalmological and neurological ones. In some cases, severely altered cerebral blood flow can present as massive life-threatening bleeding through the nose, subarachnoid hemorrhage, and\/or intraparenchymal hemorrhage. Although intuitively it makes sense that the elevation of venous pressure can obstruct the absorption of cerebrospinal fluid after the formation of a CCF, reports of CCFs presenting with acute acquired hydrocephalus do not exist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>This case illustrates the development of hydrocephalus in a patient with a direct CCF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>In the absence of a direct path of access to the cavernous sinus due to occlusion of the carotid artery and difficult venous access, a transcirculation route was used to obliterate the CCF and resolve the hydrocephalus in this patient.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24618\">https:\/\/thejns.org\/doi\/10.3171\/CASE24618<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24618","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T01:51:52Z","timestamp":1737942712000},"source":"Crossref","is-referenced-by-count":0,"title":["Transcirculation repair of a direct carotid-cavernous fistula in a patient who presented with hydrocephalus: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"Vsevolod","family":"Shurkhay","sequence":"first","affiliation":[{"name":"The Trauma and Neuroscience Institutes, St. John\u2019s Hospital and Medical Center, Tulsa, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon L.","family":"King","sequence":"additional","affiliation":[{"name":"The Trauma and Neuroscience Institutes, St. John\u2019s Hospital and Medical Center, Tulsa, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler S.","family":"Auschwitz","sequence":"additional","affiliation":[{"name":"The Trauma and Neuroscience Institutes, St. John\u2019s Hospital and Medical Center, Tulsa, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Charles","sequence":"additional","affiliation":[{"name":"The Trauma and Neuroscience Institutes, St. John\u2019s Hospital and Medical Center, Tulsa, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Yashar S.","family":"Kalani","sequence":"additional","affiliation":[{"name":"The Trauma and Neuroscience Institutes, St. John\u2019s Hospital and Medical Center, Tulsa, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"bib1","series-title":"Rad Case Rep","first-page":"1955","article-title":"Traumatic carotid-cavernous fistula: a case report","volume":"17","author":"Hamedani","year":"2022","unstructured":"Hamedani HHellmann DBoyce WAlesio ND. Traumatic carotid-cavernous fistula: a case report. Rad Case Rep. 2022;17(6):1955-1958."},{"issue":"2","key":"bib2","series-title":"Eye (Lond)","first-page":"164","article-title":"Carotid-cavernous fistula: current concepts in aetiology, investigation, and management","volume":"32","author":"Henderson","year":"2018","unstructured":"Henderson ADMiller NR. Carotid-cavernous fistula: current concepts in aetiology, investigation, and management. 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Surv Ophthalmol. 2021;66(4):668-673."},{"issue":"12","key":"bib8","series-title":"BMJ Case Rep","first-page":"e238746","article-title":"Isolated contralateral abducens palsy in direct carotid-cavernous fistula","volume":"13","author":"Jain","year":"2020","unstructured":"Jain CMehta ABhatia VGupta P. Isolated contralateral abducens palsy in direct carotid-cavernous fistula. BMJ Case Rep. 2020;13(12):e238746."},{"issue":"1","key":"bib9","series-title":"BJR Case Rep","first-page":"20180028","article-title":"Isolated trochlear nerve (cranial nerve IV) palsy in a patient with carotid-cavernous fistula","volume":"5","author":"Durgam","year":"2019","unstructured":"Durgam AHussain HNakatsuka ASRaghuram K. Isolated trochlear nerve (cranial nerve IV) palsy in a patient with carotid-cavernous fistula. 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World Neurosurg X. 2023;19:100189."},{"issue":"3","key":"bib26","series-title":"Cardiovasc Intervent Radiol","first-page":"679","article-title":"Embolization of direct carotid cavernous fistula with Onyx and coils under transarterial balloon protection","volume":"37","author":"Yu","year":"2014","unstructured":"Yu YLi QHuang Q, et al. Embolization of direct carotid cavernous fistula with Onyx and coils under transarterial balloon protection. Cardiovasc Intervent Radiol. 2014;37(3):679-685."},{"key":"bib27","series-title":"Clin Neurol Neurosurg","first-page":"107700","article-title":"Efficiency of endovascular management with a combination of Onyx and coils for direct and indirect carotid cavernous fistula treatment: experience of a single center","volume":"228","author":"Ma","year":"2023","unstructured":"Ma YLi ZZhang TChen HChen XZhao W. Efficiency of endovascular management with a combination of Onyx and coils for direct and indirect carotid cavernous fistula treatment: experience of a single center. Clin Neurol Neurosurg. 2023;228:107700."},{"issue":"4","key":"bib28","series-title":"Interv Neuroradiol","first-page":"461","volume":"20","author":"Chi","year":"2014","unstructured":"Chi CTNguyen DDuc VTChau HHSon VT. Direct traumatic carotid cavernous fistula: angiographic classification and treatment strategies study of 172 cases. Interv Neuroradiol. 2014;20(4):461-475."},{"issue":"7","key":"bib29","series-title":"Acta Neurochir","first-page":"1125","article-title":"Use of Pipeline Embolization Devices for treatment of a direct carotid-cavernous fistula","volume":"157","author":"Nossek","year":"2015","unstructured":"Nossek EZumofen DNelson E, et al. Use of Pipeline Embolization Devices for treatment of a direct carotid-cavernous fistula. Acta Neurochir. 2015;157(7):1125-1130."},{"issue":"5","key":"bib30","series-title":"Interv Neuroradiol","first-page":"569","article-title":"Direct carotid-cavernous fistula: a complication of, and treatment with, flow diversion","volume":"22","author":"Amuluru","year":"2016","unstructured":"Amuluru KAl-Mufti FGandhi CDPrestigiacomo CJSingh IP. Direct carotid-cavernous fistula: a complication of, and treatment with, flow diversion. Interv Neuroradiol. 2016;22(5):569-576."},{"issue":"4","key":"bib31","series-title":"Clin Neurorad","first-page":"493","article-title":"Direct carotid cavernous sinus fistulae: vessel reconstruction using flow-diverting implants","volume":"27","author":"Wendl","year":"2016","unstructured":"Wendl CMHenkes HMoreno RMGanslandt OB\u00e4zner HP\u00e9rez MA. Direct carotid cavernous sinus fistulae: vessel reconstruction using flow-diverting implants. 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Radiologie (Heidelb). 2024;64(3):182-188."},{"issue":"6","key":"bib6","series-title":"J Fr Ophtalmol","first-page":"462","article-title":"Fistules carotido-caverneuses: corr\u00e9lation anatomo-clinique","volume":"37","author":"Fel","year":"2014","unstructured":"Fel ASzatmary ZSourour NBodaghi BLeHoang PTouitou V. Fistules carotido-caverneuses: corr\u00e9lation anatomo-clinique. J Fr Ophtalmol. 2014;37(6):462-468."},{"issue":"4","key":"bib7","series-title":"Surv Ophthalmol","first-page":"668","article-title":"A shotgun wedding","volume":"66","author":"Ekeh","year":"2021","unstructured":"Ekeh LDermarkarian CRForoozan RBhatti MT. A shotgun wedding. Surv Ophthalmol. 2021;66(4):668-673."},{"issue":"12","key":"bib8","series-title":"BMJ Case Rep","first-page":"e238746","article-title":"Isolated contralateral abducens palsy in direct carotid-cavernous fistula","volume":"13","author":"Jain","year":"2020","unstructured":"Jain CMehta ABhatia VGupta P. 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Acute onset variable and progressive trochlear nerve palsy and ophthalmoparesis secondary to bilateral carotid cavernous fistula. J Binocul Vis Ocul Motil. 2021;71(2):50-54."},{"issue":"3","key":"bib11","series-title":"No Shinkei Geka","first-page":"235","article-title":"Case of direct carotid-cavernous fistula presenting with subarachnoid hemorrhage","volume":"40","author":"Asano","year":"2012","unstructured":"Asano THoukin KMoriwaki TNiiya YMabuchi S. Case of direct carotid-cavernous fistula presenting with subarachnoid hemorrhage. Article in Japanese. No Shinkei Geka. 2012;40(3):235-239."},{"issue":"11","key":"bib12","series-title":"Acta Neurochir","first-page":"1201","article-title":"Air in the carotid canal as a predictor of distal internal carotid artery laceration","volume":"148","author":"Buis","year":"2006","unstructured":"Buis DRDirven CMFVan Den Berg RManoliu RAVandertop WP. Air in the carotid canal as a predictor of distal internal carotid artery laceration. 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