Direct carotid-cavernous fistulas are a rare complication of craniofacial trauma that often presents with proptosis, chemosis, and other visual symptoms. Disruption of blood flow from a carotid-cavernous fistula can cause cortical and cranial nerve ischemia which requires emergent intervention. Upon clinical suspicion of a carotid-cavernous fistula, patients should undergo computed tomography angiography (CTA) or magnetic resonance angiography (MRA), and digital subtraction angiography (DSA) if no other etiology is suspected. We present a case of a middle-aged patient with a gunshot wound in the posterior pharynx that resulted in a direct carotid-cavernous fistula of the left internal carotid artery.
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http://dx.doi.org/10.1016/j.radcr.2022.02.065 | DOI Listing |
BMJ 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.
View Article and Find Full Text PDFCureus
November 2024
Neurological Surgery, Hospital Jose Eleuterio Gonzalez, Universidad de Nuevo Leon, Monterrey, MEX.
The treatment of indirect carotid-cavernous fistula (CCF) poses a unique challenge. Currently, endovascular interventions remain the principal treatment option with high cure rates and acceptable safety profiles. The anatomical characteristics of individual cases determine the optimal vascular access routes (transvenous vs.
View Article and Find Full Text PDFNMC Case Rep J
November 2024
Department of Neurosurgery, St. Marianna University Hospital, Kawasaki, Kanagawa, Japan.
The most frequent of the embryonic persistent arteries that connect the internal carotid artery to the posterior circulation is the persistent primitive trigeminal artery (PPTA), which is recognized on 0.1%-0.6% on the basis of conventional angiography or magnetic resonance imaging (MRI).
View Article and Find Full Text PDFCureus
November 2024
Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, MYS.
A carotid-cavernous fistula (CCF) involves an abnormal communication between the carotid artery and the cavernous sinus. For indirect CCF, it usually occurs in post-menopausal women. Contralateral symptoms for indirect CCF are rare.
View Article and Find Full Text PDFOman J Ophthalmol
October 2024
Department of Ophthalmology, Minto Ophthalmic Hospital, Regional Institute of Ophthalmology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
Carotid-cavernous fistula (CCF) is a rare condition involving an abnormal communication between the carotid artery and the cavernous sinus. We present a unique case of posttraumatic unilateral CCF initially misdiagnosed as a corneal melt with iris prolapse and orbital cellulitis. The patient, a 25-year-old male, experienced swelling, bleeding, and sudden vision loss in the affected eye following a fall.
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