Endovascular therapy using flow diversion for giant internal carotid artery pseudoaneurysm arising in the setting of an invasive pituitary macroadenoma.

This report illustrates the unusual occurrence of a pseudoaneurysm arising in the setting of a skull base mass and describes the first reported use of endovascular flow diversion therapy in such a setting. A 63-year-old man with occasional headaches during the preceding month presented with the acute onset of severe left retroorbital headache and oculomotor nerve palsy. Computed tomography (CT) and CT angiogram revealed a destructive skull base mass with an associated giant probable pseudoaneurysm of the cavernous segment of the left internal carotid artery.

Dementia caused by dural arteriovenous fistulas reversed following endovascular therapy.

We describe two patients who presented with dementia as the primary neurological manifestation of their dural arteriovenous fistula (dAVF). Although dementia is not the most common presentation for a dAVF, these cases show that obliterating the fistula can eliminate this dreadful manifestation. This awareness may facilitate the diagnosis of dementia in cases caused by dAVF and allow for a minimally invasive treatment that restores cognitive function back to baseline.

Multidisciplinary treatment of a large cerebral dural arteriovenous fistula using embolization, surgery, and radiosurgery.

Dural arteriovenous fistulae are rare lesions composed of abnormal connections between meningeal arteries and the dural sinuses or lepto-meningeal veins. Treatment is challenging because of the small size and wide distribution of the myriad sites of fistulous connection. We present a case of a dural arteriovenous fistula presenting with visual deterioration, pulsatile tinnitus, and intracranial hypertension that was successfully treated with a multidisciplinary approach combining angiographic, surgical, and radiosurgical intervention.

Use of covered stent grafts in the extracranial carotid artery: report of three patients with follow-up between 8 and 42 months.

Currently, most carotid artery pathologic abnormalities resulting in pseudoaneurysm formation or stenosis are repaired by surgical intervention. Because surgical intervention requires proximal and distal control of the artery, pseudoaneurysms near the skull base may be very difficult to repair and pose greater risk to the patient. As a result, endovascular techniques have evolved in an effort to reduce morbidity associated with surgical techniques.