Spontaneous carotid—jugular fistula and carotid dissection in a patient with multiple intracranial arachnoid cysts and hemifacial atrophy: a generalized connective tissue disorder?

Case report

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  • 1 Departments of Neurologic Surgery and Diagnostic Radiology, Mayo Clinic, Rochester, Minnesota
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✓ The authors report a case of a 45-year-old woman with pulsatile tinnitus who was found to have an unusual spontaneous fistula between the petrous internal carotid artery and internal jugular vein. The fistula resolved spontaneously, possibly related to daily manual compression of the ipsilateral common carotid artery. The patient also had a contralateral carotid artery dissection, multiple intracranial arachnoid cysts, and hemifacial atrophy. Her medical history was significant for easy bruisibility, abnormal scarring, and mitral valve prolapse. This association appears unique and may represent a previously undescribed generalized connective tissue disorder.

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Contributor Notes

Address reprint requests to: Wouter I. Schievink, M.D., Department of Neurologic Surgery, Mayo Clinic, 200 First Street, SW, Rochester, Minnesota 55905.
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