We report the case of an 85-year-old patient, referred by her ophthalmologist for neuro-ophthalmologic consultation at the Clermont-Ferrand University Medical Center, for conjunctival hyperemia and ocular hypertension in the left eye for 12 months. The patient's only past medical history was treated, controlled arterial hypertension and there was no mention of falling or head trauma. MRI (magnetic resonance imaging) and angiography identified a type D carotid-cavernous fistula. Intravenous embolization was performed under general anesthesia by retrograde selective catheterization facial vein and ophthalmic vein and placement of coils into the cavernous sinus, resulting in regression of physical and functional signs immediately after the procedure. This case illustrates the symptoms of spontaneous carotid-cavernous fistula and immediate efficacy of embolization. We report the epidemiology, characteristics and various presentations of the condition.
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http://dx.doi.org/10.1016/j.jfo.2013.05.011 | DOI Listing |
Orbit
January 2025
Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway.
Purpose: Carotid-cavernous fistulas (CCFs) are treated almost exclusively by endovascular techniques, but the frequency of treatments is limited in smaller centers. We analyzed all CCFs treated in our hospital to determine if high-quality treatment of CCFs can be provided in a medium-volume neurovascular center.
Methods: Retrospective quality-control cohort study.
Cureus
December 2024
Department of Ophthalmology, Hospital University Kebangsaan Malaysia, Kuala Lumpur, MYS.
We report a rare case of a missed intracavernous internal carotid artery dissecting aneurysm occurring as a complication of the base of skull fracture with severe brain injury causing acute cavernous sinus syndrome with permanent vision loss. A 31-year-old Myanmar lady had an alleged motor vehicle accident and suffered severe traumatic brain injury with multiple intracranial bleeds, multiple facial bone and base of skull fractures, and limb fractures. At one week post-trauma, she had severe right eye proptosis with vision loss, ophthalmoplegia, chemosis, and high intraocular pressure.
View Article and Find Full Text PDFMedicina (Kaunas)
December 2024
Department of Neurosurgery, Chung Shan Medical University Hospital, Taichung City 402, Taiwan, China.
Traumatic direct type carotid cavernous fistula (CCF) is an acquired arteriovenous shunt between the carotid artery and the cavernous sinus post severe craniofacial trauma or iatrogenic injury. We reported a 46-year-old woman who had developed a traumatic direct type CCF after severe head trauma with a skull base fracture and brain contusion hemorrhage. The clinical manifestations of the patient included pulsatile exophthalmos, proptosis, bruits, chemosis, and a decline in consciousness.
View Article and Find Full Text PDFCureus
December 2024
Department of Neurosurgery, ProMedica Toledo Hospital, Toledo, USA.
A carotid cavernous fistula (CCF) is a disruption in the carotid arteries within the cavernous sinus. The pooling of blood in the sinus causes a myriad of neurological deficits. When correctly diagnosed, this condition can be easily managed through surgical intervention.
View Article and Find Full Text PDFBMJ Case Rep
December 2024
Pontificia Universidad Catolica del Ecuador, Quito, Pichincha, Ecuador.
Carotid-cavernous aneurysms (CCAs) have the potential for growth, and their risk of rupture can lead to severe complications. Treatment is typically recommended to prevent these complications, with endovascular therapy being the preferred approach due to the challenging surgical access. This case presents a rare instance of rupture of a CCA that had been previously treated with a flow-diverting stent, which resulted in the development of a carotid-cavernous fistula, requiring venous access endovascular treatment.
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