Incidentally Discovered Direct Carotid-Cavernous Fistula in a Patient With Anterior Choroidal Artery Territory Infarction

Direct carotid cavernous fistula (CCF), which is an abnormal communication between the intracavernous carotid artery and the cavernous sinus, is a very rare condition that is generally associated with head trauma, intracavernous aneurysms, and certain connective-tissue diseases. The case of a patient with an infarction in the anterior choroidal artery territory is described herein. Cerebral angiography was performed during consecutive workups to investigate the discrepancy between the magnetic resonance angiography data. An unexpected direct CCF of the ipsilateral side of the infarction was found. It is possible that the CCF had influenced the development of the infarction in the anterior choroidal artery territory.

Incidentally Discovered Direct Carotid-Cavernous Fistula in a Patient With Anterior Choroidal Artery Territory Infarction

Direct carotid cavernous fistula (CCF), which is an abnormal communication between the intracavernous carotid artery and the cavernous sinus, is a very rare condition that is generally associated with head trauma, intracavernous aneurysms, and certain connective-tissue diseases. The case of a patient with an infarction in the anterior choroidal artery territory is described herein. Cerebral angiography was performed during consecutive workups to investigate the discrepancy between the magnetic resonance angiography data. An unexpected direct CCF of the ipsilateral side of the infarction was found. It is possible that the CCF had influenced the development of the infarction in the anterior choroidal artery territory.

Initial Orthostatic Hypotension is Possibly Associated with Autonomic Dysfunction when Diagnosed with a Tilt Table Test / 대한소아신경학회지

PURPOSE: Initial orthostatic hypotension is typically associated with active standing and normal autonomic function. Some adolescents in the present study displayed initial orthostatic hypotension during passive tilting, and we hypothesized that this condition was due to abnormal autonomic function. METHODS: The present study compared autonomic functioning in two groups of adolescents: patients with a diagnosis of initial orthostatic hypotension according to the tilt table test and patients with typical symptoms of initial orthostatic hypotension but normal tilt table test results. RESULTS: Significantly higher total composite autonomic severity scores and considerably higher adrenergic index were noted in the tilt table tested group. CONCLUSION: Initial orthostatic hypotension is possibly associated with autonomic dysfunction, especially abnormal vasoconstrictive ability, in individuals diagnosed with a tilt table test. Clinicians should take note of autonomic function when performing diagnoses of initial orthostatic hypotension using the tilt table test.