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1.
BMJ Case Rep ; 13(12)2020 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-33361137

RESUMO

Endovascular thrombectomy in acute ischaemic stroke commonly uses aspiration catheters, either alone or in combination with stent retrievers. The Penumbra Aspiration System (Penumbra, Alameda, California, USA) was first approved by the US Food and Drug Administration in 2007, with low reported device-related complications. We present a case of a previously unreported complication related to malfunction of a Penumbra aspiration catheter during stroke thrombectomy resulting in a carotid-cavernous fistula.


Assuntos
Fístula Carotidocavernosa , Angiografia por Tomografia Computadorizada/métodos , Falha de Equipamento , Infarto da Artéria Cerebral Média , Complicações Intraoperatórias , Artéria Cerebral Média , Trombectomia , Dispositivos de Acesso Vascular/efeitos adversos , Idoso , Fístula Carotidocavernosa/diagnóstico , Fístula Carotidocavernosa/etiologia , Fístula Carotidocavernosa/cirurgia , Análise de Falha de Equipamento , Feminino , Humanos , Infarto da Artéria Cerebral Média/complicações , Infarto da Artéria Cerebral Média/diagnóstico , Infarto da Artéria Cerebral Média/cirurgia , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/cirurgia , /fisiopatologia , Artéria Cerebral Média/diagnóstico por imagem , Artéria Cerebral Média/cirurgia , Trombectomia/efeitos adversos , Trombectomia/instrumentação , Trombectomia/métodos , Resultado do Tratamento
2.
BMJ Case Rep ; 13(12)2020 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-33370953

RESUMO

Post-traumatic direct carotid-cavernous fistulas may develop in patients with a closed head injury. The classical presentation is the Dandy's triad-chemosis, pulsatile proptosis and orbital bruit. Associated findings may include orbital pain, dilated episcleral corkscrew vessels, vision deficit and cranial nerve palsies. Cranial nerves-oculomotor (III), trochlear (IV), ophthalmic (V1), and maxillary (V2) divisions of trigeminal and the abducens (VI) lie in close association of the cavernous sinus. Abducens nerve (VI) lies close to the intracavernous internal carotid artery, within the substance of the sinus and is hence easily susceptible to vascular insult. The two sinuses connect across the midline and communicate freely with each other. Back pressure changes can present with the same sided or bilateral cranial nerve palsies. We report a rare association of a long-standing left-sided carotid-cavernous fistula with right eye abduction deficit and contralateral abducens palsy.


Assuntos
Doenças do Nervo Abducente/etiologia , Fístula Carotidocavernosa/diagnóstico , Exoftalmia/etiologia , Traumatismos Cranianos Fechados/complicações , Angiografia Digital , Artéria Carótida Interna/diagnóstico por imagem , Fístula Carotidocavernosa/etiologia , Fístula Carotidocavernosa/cirurgia , Seio Cavernoso/diagnóstico por imagem , Criança , Procedimentos Endovasculares , Exoftalmia/cirurgia , Humanos , Masculino , Tomografia Computadorizada por Raios X , Resultado do Tratamento
3.
Cesk Slov Oftalmol ; 1(Ahead of print): 1-8, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33086846

RESUMO

Carotid-cavernous fistula (CCF) is an abnormal communication - vascular connection between arteries and veins in the cavernous sinus. Classification according to etiology is traumatic vs spontaneous. According to blood flow rate per high flow vs low flow fistula. According to anatomy of direct vs indirect: Direct (direct) CCF arises through direct communication between the internal carotid artery (ICA) and the cavernous sinus. Indirect CCF originates through indirect communication through the meningeal branches of ICA, external carotid artery and cavernous sinus (not directly with ICA) and Barrow type A, B, C, D division. Patients subjective complaints depend on the type of CCF. Most often it is pulsating tinnitus, synchronous with blood pulse. Typical findings include protrusion and pulsation of the eyeball, corkscrew vessels - arterialization of conjunctival and episleral vessels, increased intraocular pressure, not responding to local antiglaucomatous therapy, keratopathy a lagophthalmo, corneal ulcers. In the later untreated stages of CCF, secondary, venous stasis or central retinal vein occlusion can occur. Diagnostic procedures include B-scan and color Doppler ultrasonography, digital ophthamodynamometry, computer tomography, nuclear magnetic resonance and digital subtraction angiography. CCF can simulate orbitopathy, conjunctivitis symptoms, carotid occlusion, scleritis or cavernous sinus thrombosis. The ophthalmologist should recognize and indicate the necessary examinations in a timely manner. The therapy is ophthalmological, neuroradiological, sterotactic, surgical and conservative.


Assuntos
Fístula Carotidocavernosa , Seio Cavernoso , Fístula , Oftalmologistas , Fístula Carotidocavernosa/diagnóstico , Fístula Carotidocavernosa/etiologia , Fístula Carotidocavernosa/terapia , Humanos , Imagem por Ressonância Magnética
4.
J Vis Exp ; (159)2020 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-32510491

RESUMO

Carotid cavernous fistula (CCF) is a rare disease caused by abnormal communications between the internal carotid artery (direct fistula) or meningeal branches of the external carotid artery (indirect fistula) and the cavernous sinus (CS). Trauma is the most common cause of CCF. The clinical presentation of CCF is closely related to the venous drainage pattern. Orbital and neuro-ophthalmological symptoms are the most common clinical presentation of CCF with drainage through the superior ophthalmic vein (SOV). Endovascular embolization by arterial or venous approaches is the most common management of CCF. Transvenous embolization using detachable coils and ethylene-vinyl alcohol copolymer (EVOH) is an alternative method for the treatment of CCF. Endovascular embolization offers different options to treat CCF by minimally invasive approach decreasing morbidity and residual fistulas. The purpose of this article is to report our treatment experiences via the inferior petrosal sinus (IPS), and immediate-term outcomes of endovascular embolization of CCF by using detachable coils and EVOH.


Assuntos
Fístula Carotidocavernosa/terapia , Seio Cavernoso/efeitos dos fármacos , Embolização Terapêutica/métodos , Polivinil/farmacologia , Fístula Carotidocavernosa/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
6.
J Glaucoma ; 28(12): 1074-1078, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31658226

RESUMO

PRECIS: Secondary ocular hypertension (OHT) is common in carotid-cavernous fistulas (CCFs). Management of elevated intraocular pressure (IOP) is possible with a multidisciplinary approach. The ipsilateral normal eyes may have higher IOP than the contralateral eyes. PURPOSE: To study the IOP profile of the eyes of patients with a CCF, treatment outcomes for elevated IOP, and intereye IOP asymmetry in the eyes with normal IOP. METHODS: This was a retrospective case series. A total of 64 eyes of 60 patients with digital subtraction angiography-proven CCF diagnosed from the year 2000 to 2016 were included. The demographics, clinical features, management, and outcomes were recorded. The primary outcome included understanding of the cause of elevated IOP. The secondary outcomes included comparison of the IOP between contralateral eyes and ipsilateral normal eyes (IOP <21 mm Hg) and management outcomes for elevated IOP. RESULTS: The mean age of the patients was 45.6±18.2 years. In the study population, 70% of the patients were males. Indirect CCF was present in 55% of the eyes. It was found that 64.06% (n=41) of the eyes had elevated IOP, glaucoma, or were glaucoma suspects. Among all the eyes, 40.62% (n=26) of the eyes had secondary OHT due to elevated episcleral venous pressure, whereas 7.81% (n=5) of the eyes had secondary open-angle glaucoma. The mean IOP was higher in the ipsilateral eyes than in the other eyes (22.95±7.1vs. 15.11±2.99 mm Hg; P<0.001). The mean IOP in the ipsilateral normal eyes was higher than that in the contralateral eyes, with a mean difference of 2.92±2.29 mm Hg (confidence interval of the mean difference: 1.90-3.94 mm Hg; P<0.0001). IOP reduction (<21 mm Hg) was achieved in 70.7% of the patients following CCF management with intermittent carotid massage, endovascular treatment, IOP-lowering medications, or a combination among these. CONCLUSIONS: Secondary OHT due to elevated episcleral venous pressure was more common than secondary open-angle glaucoma. Ipsilateral normal eyes had higher IOP than contralateral eyes. IOP-lowering agents and management of CCF resulted in IOP control in most patients.


Assuntos
Fístula Carotidocavernosa/fisiopatologia , Glaucoma de Ângulo Aberto/fisiopatologia , Pressão Intraocular/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/uso terapêutico , Fístula Carotidocavernosa/diagnóstico , Fístula Carotidocavernosa/terapia , Criança , Pré-Escolar , Embolização Terapêutica , Feminino , Glaucoma de Ângulo Aberto/diagnóstico , Glaucoma de Ângulo Aberto/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/diagnóstico , Hipertensão Ocular/tratamento farmacológico , Hipertensão Ocular/fisiopatologia , Estudos Retrospectivos , Tonometria Ocular , Resultado do Tratamento
7.
PLoS One ; 14(10): e0223488, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31622360

RESUMO

PURPOSE: Endovascular embolization nowadays is a well-established treatment option for direct carotid cavernous fistulas (dCCF, Barrow Type A). There are many publications on the complication and success rates of this method. However, little is known on the patients´ opinion on the treatment result after several years. We report on this issue also including the "pioneer patients" treated almost two decades ago. METHODS: We retrospectively reviewed the records of all patient (n = 25) with a more than 24 months follow-up interval after endovascular treatment of a dCCF at our institution from 01/1999 to 08/2018. We determined primary therapy success, complication rate, state of the fistula in the last imaging follow-up and quoted the patient's subjective perception of the long-term treatment success using a standardized interview form. RESULTS: Occlusion rate in the last imaging follow up was 96% (24/25) with a complication rate of 8% (2/25). The response rate on our interview request was 96% (24/25) with a rate of considered feedback of 84% (21/25 patients). Duration of our observation interval for the patient reported outcome was 143 months / 11 years (median, range: 35-226 m / 2-18 y). Most of them (21/25, 84%) felt they benefited from the treatment. CONCLUSIONS: Endovascular supply of dCCF is a highly effective treatment method leading to a sustainable therapy success with long-lasting stable subjective benefit even to our "pioneer patients" treated almost two decades ago.


Assuntos
Fístula Carotidocavernosa/terapia , Embolização Terapêutica , Procedimentos Endovasculares , Adulto , Idoso , Fístula Carotidocavernosa/diagnóstico , Fístula Carotidocavernosa/etiologia , Angiografia Cerebral/métodos , Terapia Combinada/efeitos adversos , Terapia Combinada/métodos , Embolização Terapêutica/efeitos adversos , Embolização Terapêutica/métodos , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Complicações Pós-Operatórias , Estudos Retrospectivos , Adulto Jovem
9.
Tunis Med ; 97(1): 145-148, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31535707

RESUMO

PURPOSE: to report a case of a woman who had a severe cranial trauma complicated by two ophalmologic potentially cecitating complications: right carotido-cavernous fistula and left traumatic optic neuropathy. OBSERVATION: A 56 years-old woman, without any medical history, referred, one month after fall from a height of 3 meters, for right exophthalmos. Ophthalmic examination of the right eye completed by retinal angiography suspected carotid-cavernous fistula which was confirmed by angio-MRI. In the left eye, the visual acuity was decreased to no light perception and fundus examination showed optic nerve head palor secondary to traumatic optic neuropathy. Arterial embolization was performed and allowed closing of the fistula. CONCLUSION: Optic neuropathy and carotido-cavernous fistula are two severe complications that can occur simultaneously in the same patient. The prognosis of the optic neuropathy may be compromised, and the treatment of carotido-cavernous fistula benefited from progress in interventional neuro-radiology.


Assuntos
Fístula Carotidocavernosa/etiologia , Traumatismos Craniocerebrais/complicações , Doenças do Nervo Óptico/etiologia , Fístula Carotidocavernosa/diagnóstico , Fístula Carotidocavernosa/terapia , Seio Cavernoso/patologia , Traumatismos Craniocerebrais/diagnóstico , Traumatismos Craniocerebrais/terapia , Embolização Terapêutica , Exoftalmia/diagnóstico , Exoftalmia/etiologia , Exoftalmia/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Doenças do Nervo Óptico/diagnóstico , Doenças do Nervo Óptico/terapia , Resultado do Tratamento
10.
Am J Ophthalmol ; 206: 264-273, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31226247

RESUMO

PURPOSE: To define the retinal and choroidal imaging findings of carotid cavernous fistula (CCF) including central foveal thickness, subfoveal choroidal thickness, choroidal vascularity index (CVI) parameters, and tortuosity indexes (TIs) as compared to a control group (CG). DESIGN: Cross-sectional study. MATERIALS AND METHODS: The spectral domain enhanced-depth imaging optical coherence tomography images of 19 eyes of 19 consecutive patients with angiographically proven CCF and 19 eyes of 19 age- and sex-matched healthy control subjects were included. The patient group was divided according to CCF venous drainage pattern as anterior (A-CCF: draining into ophthalmic veins) and posterior (P-CCF: not draining into ophthalmic veins). The clinically affected eyes of the patient group, ipsilateral to the fistula, were included in the analysis. RESULTS: There were 15 A-CCFs (78.9%) and 4 P-CCFs (21.1%). The mean SFCT of the A-CCF group (395.21 ± 111.69 µm) was significantly higher than those of the P-CCF (246.84 ± 94.12 µm) and CG groups (280.79 ± 111.36 µm) (P = .039 and P = .006, respectively). The mean CVI of the A-CCF group was significantly higher than that of the CG (68.97 ± 4.81 and 65.66 ± 3.37, respectively, P = .033). The A-CCF group had significantly higher inferior, superior, and total venous TI than the CG group (P = .001, P = .001, and P < .001, respectively). CONCLUSION: In this first study investigating the CVI and TI in CCF patients, we demonstrated that SFCT, CVI, and TI could potentially be used to aid in the diagnosis of A-CCF.


Assuntos
Fístula Carotidocavernosa/diagnóstico , Doenças da Coroide/diagnóstico , Corioide/patologia , Fóvea Central/patologia , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Angiografia , Estudos Transversais , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Acuidade Visual , Adulto Jovem
12.
BMC Ophthalmol ; 19(1): 48, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30744702

RESUMO

BACKGROUND: Painful ophthalmoplegia can be caused by various etiologies, and broad differential diagnosis is needed. Carotid-cavernous fistula (CCF) is a rare cause of painful ophthalmoplegia, and early diagnosis is quite difficult. CASE PRESENTATION: Here, we present a case of paroxysmal painful ophthalmoplegia caused by CCF. The episodic symptoms were nonstereotypical and lasted minutes to hours. Magnetic resonance imaging (MRI) and computed tomography angiography (CTA) results were normal, which confounded efforts to determine a diagnosis. Subsequently, digital subtraction angiography (DSA) revealed a posterior-draining CCF. The CCF was treated at an early stage without residual symptoms. CONCLUSIONS: We propose that symptoms could be relapsing or remitting during an early stage of CCF and that posterior-draining CCF is prone to misdiagnosis due to atypical manifestations. Normal CTA results cannot exclude carotid-cavernous fistula, and DSA should be performed once CCF is suspected.


Assuntos
Fístula Carotidocavernosa/diagnóstico , Síndrome de Tolosa-Hunt/diagnóstico , Angiografia Digital , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade
14.
Pan Afr Med J ; 34: 204, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32180878

RESUMO

Posttraumatic carotid-cavernous fistula (CCF) is a very rare complication that can occur in patients with craniomaxillofacial trauma. It is defined by abnormal communication between arteries and veins located in the cavernous sinus. CCFs can be divided into two groups: direct, which are usually post traumatic and classically with a high flow and acute onset of symptoms. On the other hand, indirect CCFs are in the most of cases idiopathic and typically insidious of onset. The aim of the present case report is to describe an atypical presentation of direct CCF characterized by the insidious onset of symptoms with the goal to think about this rare complication and so not to delay the treatment which is an emergency in this case.


Assuntos
Fístula Carotidocavernosa/diagnóstico , Traumatismos Craniocerebrais/complicações , Exoftalmia/etiologia , Adulto , Fístula Carotidocavernosa/complicações , Humanos , Masculino
15.
Surv Ophthalmol ; 64(2): 248-253, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29024673

RESUMO

An 82-year-old woman presented with right-sided proptosis, chemosis, and a supraorbital bruit. A dural carotid-cavernous fistula was suspected, but catheter angiography revealed an intraorbital inferior ophthalmic vein arteriovenous fistula supplied by the right ophthalmic artery and infraorbital branch of the internal maxillary artery. A primary orbital arteriovenous fistula can mimic the clinical and radiographic features of the more common carotid-cavernous fistula.


Assuntos
Fístula Arteriovenosa/diagnóstico por imagem , Fístula Carotidocavernosa/diagnóstico , Artéria Maxilar/anormalidades , Artéria Oftálmica/anormalidades , Doenças Orbitárias/diagnóstico por imagem , Veias/anormalidades , Acidentes de Trânsito , Idoso de 80 Anos ou mais , Fístula Arteriovenosa/terapia , Lesões Encefálicas/etiologia , Angiografia Cerebral , Diagnóstico Diferencial , Diplopia/diagnóstico , Embolização Terapêutica/métodos , Dor Ocular/diagnóstico , Feminino , Humanos , Artéria Maxilar/diagnóstico por imagem , Artéria Oftálmica/diagnóstico por imagem , Doenças Orbitárias/terapia , Tomografia Computadorizada por Raios X , Veias/diagnóstico por imagem , Transtornos da Visão/diagnóstico
16.
World Neurosurg ; 122: e390-e398, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30352308

RESUMO

BACKGROUND: The purpose of the present study was to describe our single-institutional experience of treating direct carotid-cavernous fistulas (DCCFs) with Willis covered stents (WCSs). METHODS: Of a total of 31 DCCFs, 10 were treated with WCSs (Microport, Shanghai, China) at West China Hospital from January 2015 to December 2016. The indications for treatment, perioperative findings, and postoperative and follow-up results were collected and analyzed. RESULTS: All 10 patients had successful deployment of WCSs. Complete exclusion of the fistula was achieved in 6 patients immediately after deployment of 1 stent. Endoleak was observed in 4 patients (patients 2, 4, 5, and 9). Thus, repeat dilation of the stent with greater pressure was performed, which resolved the endoleak in 2 patients (patients 2 and 9). The endoleak of the other 2 patients persisted after repeat dilation of the balloon. Hence, a second stent was deployed in these 2 patients (patients 4 and 5), which eliminated the endoleak in patient 4. However, patient 5 continued to have a minimal endoleak. Nine patients had fistulas successfully occluded by WCSs during the follow-up period. One patient experienced recurrence of a DCCF at the 10-day follow-up point. We chose coil embolization to address this DCCF. No stenosis of the internal carotid artery or DCCF recurrence, except that in the abovementioned patient, was observed. CONCLUSIONS: WCS was proved to be an alternative treatment method for complex DCCFs through reconstruction and preservation of the internal carotid artery. Our study also confirmed the safety, efficacy, and midterm durability of WCSs for complex DCCFs without any serious delayed complications.


Assuntos
Prótese Vascular , Fístula Carotidocavernosa/cirurgia , Procedimentos Endovasculares/métodos , Stents , Adolescente , Adulto , Fístula Carotidocavernosa/diagnóstico , Fístula Carotidocavernosa/epidemiologia , China/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
18.
No Shinkei Geka ; 46(11): 989-997, 2018 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-30458436

RESUMO

Traumatic carotid cavernous fistula(CCF)is known to present a direct connection between the cavernous segment of the internal carotid artery(ICA)and the cavernous sinus(CS). In rare cases, the fistula is formed between the intradural internal carotid artery(ICA)and the cavernous sinus(CS)via a pseudoaneurysm(pAN), requiring appropriate management and aggressive surgical treatment. We describe a 58-year-old man who sustained a severe head injury diagnosed as traumatic CCF treated with an intradural pAN procedure and transarterial coil embolization combined with a Low-profile Visualized Intraluminal Support(LVIS)stent. While slow arteriovenous shunt flow persisted at the end of the surgery, the fistula was completely occluded on the digital subtraction angiography obtained 2 weeks after the procedure. It was suspected that the flow-diversion effect of the LVIS stent might have caused the curable progression of the fistula occlusion.


Assuntos
Falso Aneurisma , Fístula Carotidocavernosa , Seio Cavernoso , Embolização Terapêutica , Falso Aneurisma/diagnóstico , Falso Aneurisma/terapia , Artéria Carótida Interna , Fístula Carotidocavernosa/diagnóstico , Fístula Carotidocavernosa/terapia , Angiografia Cerebral , Humanos , Masculino , Pessoa de Meia-Idade , Stents
19.
Am J Emerg Med ; 36(12): 2336.e1-2336.e2, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30170931

RESUMO

A 73-year-old woman initially presented to our ophthalmology department with complaint of a red eye with gradual proptosis and mild restricted movement of the right eye who was misdiagnosed with conjunctivitis during 2 months. One week later she returned to the emergency department with a painful, swollen right eye and a high intraocular pressure of 41 mm Hg and limitation of her extraocular muscles in nearly all fields of gaze. As her IOP was high, she was diagnosed as having secondary glaucoma and was prescribed timolol 0.5% (twice a day) and Latanoprost eye drop at night in the right eye. During follow-up, her IOP remained in high level despite maximum medications. Computed tomography scan of the orbit showed an enlarged superior ophthalmic vein (SOV). In view of her persistent elevated IOP despite maximum medications and dilated conjunctival veins, she was advised digital subtraction angiography (DSA) and imaging revealed a carotid cavernous fistula (CCF). The purpose of this article is to describe ophthalmological complaints of CCFs to help ophthalmologist in understanding the clinical features of spontaneous CCF and avoid misdiagnosis.


Assuntos
Fístula Carotidocavernosa/diagnóstico , Fístula Carotidocavernosa/fisiopatologia , Olho/irrigação sanguínea , Órbita/diagnóstico por imagem , Idoso , Angiografia Digital , Doenças da Túnica Conjuntiva/etiologia , Erros de Diagnóstico , Diplopia/etiologia , Exoftalmia/etiologia , Feminino , Humanos , Tomografia Computadorizada por Raios X
20.
BMC Ophthalmol ; 18(1): 183, 2018 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-30045703

RESUMO

BACKGROUND: 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. 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. 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. 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.


Assuntos
Fístula Carotidocavernosa/complicações , Traumatismos Craniocerebrais/complicações , Baixa Visão/etiologia , Acidentes de Trânsito , Angiografia Digital , Fístula Carotidocavernosa/diagnóstico , Fístula Carotidocavernosa/terapia , Traumatismos Craniocerebrais/diagnóstico , Embolização Terapêutica , Humanos , Imagem por Ressonância Magnética , Masculino , Baixa Visão/diagnóstico , Acuidade Visual , Adulto Jovem
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