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2014, Number 5

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Med Int Mex 2014; 30 (5)

Carotid-cavernous fistula

Batún-Garrido JAJ, Hernández-Núñez E
Full text How to cite this article

Language: Spanish
References: 7
Page: 607-612
PDF size: 525.29 Kb.


Key words:

carotid-cavernous fistula, exophthalmos, glaucoma.

ABSTRACT

The carotid-cavernous fistula (CCF) is an abnormal connection between the carotid artery and the cavernous sinus that can be spontaneous in 25% of the cases or acquired in 75% of the cases, mainly with a traumatic origin. This entity is characterized for the presence of proptosis, chemosis, episcleral vessels with corkscrew appearance, eyeball pulsations, orbital bruits, decreases visual acuity and increases intraocular pressure. This paper reports the case of a 48-year-old male patient, without cranial trauma history, who had clinical data compatible with a spontaneous carotid-cavernous fistula. Initially he was treated as glaucoma and then as an orbital cellulitis with high doses of glucocorticoids not responding to treatment, being hospitalized in the department of internal medicine for having metabolic disorder. The diagnosis was confirmed by computed tomography angiography, the fistula was situated by pan-angiography and it was embolized by secondary intention using coils and OnyxTM.


REFERENCES

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  2. Ellis J, Goldstein H, Connolly S, Meyers P. Carotid-cavernous fistulas. Neurosurg Focus 2012;32:1-11.

  3. Korkmazer B, Kocak B, Tureci E, Islak C, et al. Endovascular treatment of carotid cavernous sinus fistula: a systematic review. World J Radiol 2013;5:143-155.

  4. Torres R. Tratamiento endovascular de fístulas carotídeocavernosas traumáticas: experiencia preliminar en Costa Rica. Neuroeje 2005;19:17-23.

  5. Charlin R, Pacheco P, Villarroel F, Urbina F. Fístula carótidocavernosa: importancia de su diagnóstico y tratamiento oportunos para prevenir la ceguera. Rev Med Chile 2004;132:1221-1226.

  6. Shinohara Y, Kashima T, Akiyama H, Kishi S. Alteration of choroidal thickness in a case of carotid cavernous fistula: a case report and a review of the literature. BMC Ophthalmology 2013;13:75-85.

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Med Int Mex. 2014;30