ABSTRACT
La fístula carotídeo-cavernosa (FCC) es una comunicación arteriovenosa anómalo-patológica, que se produce entre la arteria carótida y el seno cavernoso. Se describe el caso clínico de un paciente de 23 años de edad, masculino, que sufrió un trauma cráneo-encefálico por un accidente automovilístico. Debido a que el paciente no mejoraba y aparecían otras manifestaciones clínicas, fue remitido a la consulta del hospital de Malange, Angola. Se le realizó examen físico general, ocular, hemoquímica y tomografía computarizada de órbita con corte axial. Se discute en colectivo con el neurocirujano del hospital y se concluye como diagnóstico una fistula carotídeo-cavernosa del ojo izquierdo de causa traumática, remitiendo el caso al hospital Josefina Machel de Luanda para valorar tratamiento quirúrgico(AU)
A carotid-cavernous fistula (CCF) is an anomalous-pathological arteriovenous communication that occurs between the carotid artery and the cavernous sinus. This study describes the case of a 23-year-old male patient who suffered a cranioencephalic trauma caused by an automobile accident. Because the patient did not improve and other clinical manifestations appeared, he was referred to the hospital of Malange, Angola. A general physical and ocular examination, biochemical tests and a computed tomography of the orbit in axial plane were performed. It was discussed collectively with the neurosurgeon of the hospital and a carotid-cavernous fistula of the left eye caused by trauma was diagnosed. The case was referred to the Josefina Machel Hospital in Luanda to assess surgical treatment(AU)
Subject(s)
Humans , Young Adult , Carotid-Cavernous Sinus Fistula , Tomography, Optical , OrbitABSTRACT
Fístulas carotídeo-cavernosas são raras. São classificadas nos tipos direto e indireto. Fístulas diretas têm uma comunicação anormal entre a artéria carótida interna e o seio cavernoso. Nas formas indiretas a conexão se faz entre os ramos meningeos da carótida interna e/ou externa e o mesmo seio. O propósito deste artigo é o de atualizar os conceitos anatômicos, clínicos, diagnósticos e terapêuticos desta situação.
Carotid cavernous fistulae are an uncommon disease. They are classified as direct or indirect. In direct fistulas there is an abnormal communication between the internal carotid artery and the cavernous sinus. Indirect forms have an abnormal bypass between the meningeal branches of the internal and/or external carotid arteries and the same sinus. The purpose of this article is to provide an overview of the anatomy of the envolved area and the clinical findings, diagnostic evaluation and treatment.
Subject(s)
Humans , Male , Female , Carotid Artery, Internal , Carotid-Cavernous Sinus Fistula/diagnosis , Carotid-Cavernous Sinus Fistula/therapy , Cavernous Sinus/anatomy & histology , Diagnosis, DifferentialABSTRACT
Carotid cavernous fistulas are a rare entity occurring as result of head trauma and also spontaneously. The authors report a rare case of central retinal artery occlusion complicating traumatic carotid-cavernous fistula, resulting in severe visual acuity loss. Spontaneous closure of the fistula was observed. The possible mechanisms responsible for this complication are discussed.
Fístulas carótido-cavernosas são raras e ocorrem como resultado de trauma cefálico e também espontaneamente. Os autores relatam um caso raro de oclusão de artéria central da retina complicando fístula carótido-cavernosa traumática, resultando em perda grave da acuidade visual. Fechamento espontâneo da fístula foi observado. Os possíveis mecanismos responsáveis por esta complicação são discutidos.