ABSTRACT
Objective. To determine the efficiency of latex detachable balloons in the treatment of post-traumatic carotid-cavernous fistulae (CCF). Methods.Management and outcome were reviewed for 34 consecutive patients with post-traumatic CCF personally treated by one of the authors (PS) using latex detachable balloons during the 4-year period 1996 - 2000. Results. Endovascular embolisation of 34 CCFs was attempted in 33 patients. In 1 patient where the fistula was a result of rupture of an intracavernous aneurysm; the fistula thrombosed spontaneously before embolisation was attempted. In the 33 treated patients; the fistula was occluded in 30 cases (91). Patency of the internal carotid artery was preserved in 16 cases (53). Conclusion. A high percentage (91) of direct CCFs were successfully occluded with latex detachable balloons. There were no permanent neurological complications in any of the patients treated
Subject(s)
TherapeuticsABSTRACT
Spontaneous epidural haematoma is rare in pregnancy and only five cases have been reported. We present a case of a 31-year-old female G2P1 who at 32 weeks of gestation developed progressive ascending paralysis and numbness to a level of approximately T4. An urgent MRI of the spine was performed, which demonstrated a posterior epidural lesion at T1-T4 level. The lesion showed signal changes consistent with an epidural haematoma in the hyperacute stage. An emergency cesarean section was performed followed by spinal decompression and removal of an epidural haematoma. The patient's neurological function subsequently improved. The diagnosis and management of spontaneous epidural haematoma in pregnancy is presented with a review of the literature.
