Post-traumatic right carotid-cavernous fistula resulting in symptoms in the contralateral eye: a case report and literature review

Linxin Zhu,Bing Liu,Jingxiang Zhong

doi:10.1186/s12886-018-0863-6

Linxin Zhu, Bing Liu + Show 1 more

Open Access

https://doi.org/10.1186/s12886-018-0863-6

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Abstract

BackgroundTo report a case of a carotid-cavernous fistula (CCF) that occurred after a motor vehicle accident and review the uniqueness of this case and the main confusing points for the diagnosis of such cases.Case presentationA 22-year-old man complained of left eyelid swelling, eye redness, visual decrease and occasional headache after motor vehicle accident 4 months prior during which he experienced a head injury. He was initially thought to have glaucoma, but he was finally diagnosed with a right CCF based on magnetic resonance imaging (MRI) and digital subtraction angiography (DSA). Timely embolization surgery resulted in obvious relief of the ocular symptoms and an improved prognosis.ConclusionThis is the first reported case of a post-traumatic unilateral CCF with contralateral symptoms in direct CCF, it is very infrequent and deserves our attention. We should maintain high suspicion of CCF and confirm the diagnosis by DSA when managing such patients to prevent serious consequences. Early diagnosis and treatment can improve the prognosis of patients.

Highlights

To report a case of a carotid-cavernous fistula (CCF) that occurred after a motor vehicle accident and review the uniqueness of this case and the main confusing points for the diagnosis of such cases.Case presentation: A 22-year-old man complained of left eyelid swelling, eye redness, visual decrease and occasional headache after motor vehicle accident 4 months prior during which he experienced a head injury
The CCF is typically divided into direct and indirect types according to the different arteriovenous shunts [2].Shunting of the blood from the carotid artery systems to the cavernous sinus (CS) increases the pressure inside the CS, causes engorgement of the draining vessels, may cause the flow to reverse, and leads to myriad clinical manifestations that mimic many
digital subtraction angiography (DSA) examination revealed a direct fistula between the right internal carotid artery and the cavernous sinus

Summary

Conclusion

This is the first reported case of a post-traumatic unilateral CCF with contralateral symptoms in direct CCF, it is very infrequent and deserves our attention. Diagnosis and treatment can improve the prognosis of patients

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