PREMATURELY DETECTED TRAUMATIC CAROTID-CAVERNOUS SINUS FISTULA, BY MEANS OF UNINTENTIONAL CONTRALATERAL INFERIOR PETROSAL SINUS CATHETERIZATION - BILATERAL JUGULAR BULB OXYGEN-SATURATION FINDINGS

A traumatic carotid-cavernous sinus fistula (CCSF) was prematurely sus pected following the detection of arterial-like hemoglobin oxygen satu ration values, sampled from a catheter placed for cerebrovenous monito ring. A high-resolution scan of jugular foramina revealed that the cat heter tip had been unintentionally placed in the inferior petrosal sin us, contralateral to the CCSF. instead of in the superior jugular bulb , Jugular bulb hemoglobin oxygen saturation (SjO(2)), ipsilateral to C CSF, later approached arterial hemoglobin oxygen saturation (SaO(2)) v alues. The possibility and consequences of unintentional catheterizati on of the inferior petrosal sinus, and of extracerebral contamination of blood in the jugular bulb due to blood in the inferior petrosal sin us, are discussed. We also discuss the reliability of SjO(2) monitorin g in the present CCSF case.