P-OT004. Recurrent direct carotid cavernous fistula after embolization, a case report

Abstract

Introduction. Carotid cavernous fistula (CCF) is a rare case defined as an abnormal communication between carotid artery and cavernous sinus. Anatomically, CCF is classified as direct and indirect. Radiological imaging with Head CT scan and CT angiography (CTA) has an important role in CCF’s diagnosis and management. Endovascular embolization technique is one of the effective management for CCF. Results. A 16-year-old male complained left cephalgia and progressive visual lost on his left eye after endovascular embolization 3 years ago. Patient was diagnosed with CCF since he was 12. From physical examination, we found negative light perception on the left eye. From the former CT angiography, there was vascular malformation, suspected as multiple arteriovenous fistula at level carotid cavernous level urged bulbus oculi for 10 mm and also at left jugular external carotid. We performed the second head CT scan and CTA, with conclusion that there was vascular malformation which urged bulbus oculi for 17 mm. Patient was administered with clopidogrel 75 mg. Conclusion. Endovascular embolization as CCF’s management is effective but recurrence can happen.