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Show 30. Reference: Barrow, D. L., Spector, R., Braun, I. F., Landman, J., Tindall, S., and Tindell, G. J.: Classification and treatment of spontaneous carotid cavernous sinus fistulas. NClIroslIrgcr.'l62: 248-256, 1985. Reprints: D. L. Barrow, M.D., Neurologic Surgery, Emorv University Clinic, 1365 Clifton Road N.E., Atlan'ta, GA 30322. Fourteen cases of spontaneous carotid cavernous sinus fistulas are reviewed and an anatomlc-angiographic classification presented. Type A are direct, high-flow shunts between the internal carotid artery and cavernous sinus. Types B, C, and 0 are duralcavernous shunts from meningeal branches of either the internal (8), external (C), or both (D) carotid arteries. Almost all patients presented with ophthalmologic svmptoms (diplopia, red eye, proptosis, decreased vision, and eve pain) or signs (dilated episcleral veins, decreased vision, elevated intraocular pressure, sixth nerve palsy, chemosis, third-nerve palsy, and disc swelling). The anatomy, chmcal manifestations, angiographic evaluation, indications for therapy, and therapeutic options for spontaneous carotid cavernous sinus are discussed. Thomas C. Spoor, M.D., FACS • • • September 1985 Literature Abstracts 31. Reference: Aland, S. M.: Pattern-reversal visual evoked potentials in patients with hydrocephalus. f. Nellrosurg. 62: 234-237, 1985. Reprints: 5. M. Alanci, Department of Clinical Neurophysiology, 51. James University Hospital, Beckett St., Leeds L-S97TF, England. Pattern-reversal visual evoked potentials were studied in 10 patients with hydrocephalus. Abnormalities consistent with optic nerve dysfunction were present in four patients. Two patients had response asymmetry to half-field stimulation, suggesting dysfunction of the visual pathways in the right hemisphere. Four patients had normal responses. Visual evoked potentials were repeated after surgical treatment of hydrocephalus and showed marked improvement in 2 of 3 patients with preoperative abnormalities. This study demonstrates that visual evoked potential abnormalities to wholeand half-field stimulation are common in patients with hydrocephalus (6 of 10 patients) even when the visual pathways are clinically normal. It suggests that these abnormalities are probably due to compression of either the posterior visual pathways in the cerebral hemisphere contralateral to the stimulated side (patients with homonymous half-field abnormalities) or the optic nerve (patients with whole-field abnormalities) by the enlarged ventricles. The study also demonstrates the value of visual evoked potentials in monitoring surgically treated hydrocephalic patients. Thomas C. Spoor, M.D., FACS 207 |
