scholarly journals Carotid-Cavernous Fistula as a Complication of Facial Trauma: A Case Report

2015 ◽  
Vol 8 (3) ◽  
pp. 239-245 ◽  
Author(s):  
Maria Lazaridou ◽  
Eleni Bourlidou ◽  
Konstantinos Kontos ◽  
Doxa Mangoudi
Keyword(s):  
Rare Complication ◽  
Facial Trauma ◽  
Trauma Symptoms ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Cavernous Sinus Syndrome ◽  
Retrobulbar Hematoma ◽  
Superior Orbital Fissure Syndrome ◽  
Craniomaxillofacial Trauma ◽  
Upper Lid

Posttraumatic carotid-cavernous fistula is a very rare complication that can occur in patients with craniomaxillofacial trauma. Symptoms involve headache, diplopia, ptosis of the upper lid, conjunctival chemosis, pulsating exophthalmos, and ophthalmoplegia. Diagnosis can be challenging because various pathologic entities can present with similar symptoms such as superior orbital fissure syndrome, orbital apex syndrome, retrobulbar hematoma, and cavernous sinus syndrome. However, accurate and early diagnosis is of utmost importance because treatment delay may lead to blindness or permanent neurologic deficits. In this article, a case of posttraumatic carotid-cavernous fistula that was twice misdiagnosed is presented.

scholarly journals Cavernous Sinus Syndrome and Traumatic Carotid-Cavernous Fistula Attributable to a Self-Inflicted BB Gunshot Injury

2017 ◽  
Vol 78 (S 01) ◽  
pp. S1-S156
Author(s):  
Christopher Marcellino ◽  
Christopher Graffeo ◽  
Avital Perry ◽  
Nicholas Wetjen ◽  
Michael Link
Keyword(s):  
Cavernous Sinus ◽  
Gunshot Injury ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Cavernous Sinus Syndrome

Carotid cavernous fistula after minimal facial trauma

1991 ◽  
Vol 71 (5) ◽  
pp. 549-551 ◽  
Author(s):  
Gregory J. Keiser ◽  
Andrew Zeidman ◽  
Bernard D. Gold
Keyword(s):  
Facial Trauma ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula

scholarly journals Carotid-Cavernous Fistula as a Complication of Panfacial Fracture: Case Report 11 Years after the Surgery

2017 ◽  
Vol 10 (1) ◽  
pp. 66-72
Author(s):  
Sylvio Luiz Costa de Moraes ◽  
AlexandreMaurity de Paula Afonso ◽  
RobertoGomes dos Santos ◽  
RicardoPereira Mattos ◽  
BrunoGomes Duarte
Keyword(s):  
Case Report ◽  
Rare Complication ◽  
Maxillofacial Surgery ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Appropriate Treatment ◽  
Craniofacial Trauma ◽  
Panfacial Fracture

The carotid-cavernous fistula (CCF) is a rare complication in patients victimized by craniofacial trauma. It involves multidisciplinary medical action. Owing to its potential complications, it is essential that maxillofacial surgery and neurosurgery specialists diagnose this condition so that appropriate treatment can be performed. The authors present a report of a case 11 years after the surgery.

scholarly journals 153 Carotid-Cavernous Fistula Causing Bradycardia Following Maxillofacial Trauma: A Case Report

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Wege ◽  
M Anabtawi
Keyword(s):  
Ct Scan ◽  
Maxillofacial Surgery ◽  
Signs And Symptoms ◽  
Facial Trauma ◽  
Blood Collection ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Tertiary Centre ◽  
Full Resolution ◽  
Orbital Space

Abstract A 53-year-old male presented to the local A&E department with a fractured mandible following a single punch to the lower face, and was admitted under Oral & Maxillofacial Surgery. A subsequent finding was chemosis, relative afferent pupillary defect, minimal soft exophthalmos, reduced visual acuity and colour vision in one eye, but with no associated trauma to the orbits. A CT scan showed no sign of other injury, no blood collection, and the small amount of orbital emphysema didn’t appear to be the cause of symptoms. A heart rate of 40bpm was observed, with ECG and telemetry ruling out cardiac causes of bradycardia. With this clinical picture and no orbital space occupying lesion or collection identified on the CT scan, an MRI of the head was requested, which showed superior ophthalmic vein occlusion, resulting in a diagnosis of a direct carotid-cavernous fistula (CCF). The proptosis increased slowly over 24 hours and became pulsatile. The patient was subsequently referred to the tertiary centre for treatment with endovascular embolisation using coils, which resulted in full resolution of the signs and symptoms. This case presents a rare acute presentation of CCF after indirect trauma. It is assumed that bradycardia was caused via the oculo-cardiac reflex. This presentation could have led to a clinical diagnosis of retrobulbar haemorrhage or tension pneumo-orbit, triggering surgical or needle decompression of the orbit. Such treatment would have had catastrophic consequences. This is a reminder to consider this rare diagnosis and cause of bradycardia after facial trauma.

scholarly journals Flow diversion in the treatment of carotid injury and carotid-cavernous fistula after transsphenoidal surgery

2015 ◽  
Vol 21 (3) ◽  
pp. 346-350 ◽  
Author(s):  
Daniela Iancu ◽  
Cheemum Lum ◽  
Muhammad E Ahmed ◽  
Rafael Glikstein ◽  
Marlise P dos Santos ◽  
...  
Keyword(s):  
Transsphenoidal Surgery ◽  
Rare Complication ◽  
Relevant Literature ◽  
Flow Diverter ◽  
Carotid Cavernous Fistula ◽  
Management Options ◽  
Cavernous Fistula ◽  
Flow Diverter Stent ◽  
Carotid Injury ◽  
Sinus Flow

We describe a case of iatrogenic carotid injury with secondary carotid-cavernous fistula (CCF) treated with a silk flow diverter stent placed within the injured internal carotid artery and coils placed within the cavernous sinus. Flow diverters may offer a simple and potentially safe vessel-sparing option in this rare complication of transsphenoidal surgery. The management options are discussed and the relevant literature is reviewed.

scholarly journals Spontaneous Healing of Iatrogenic Direct Carotid Cavernous Fistula

2012 ◽  
Vol 18 (2) ◽  
pp. 187-190 ◽  
Author(s):  
H-J. Kwon ◽  
S-C. Jin
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
Rare Complication ◽  
Posterior Segment ◽  
Carotid Cavernous Fistula ◽  
Spontaneous Healing ◽  
Cavernous Fistula ◽  
Close Observation ◽  
Direct Carotid Cavernous Fistula

Direct carotid-cavernous fistula (CCF) by selective navigation using a microcatheter or microwire is a rare complication, and its timing of treatment has not been elucidated. We report two cases of direct CCFs resulting from injury to the cavernous posterior segment of the internal carotid artery during selective navigation. We did not plan to perform emergent endovascular treatment for these direct CCFs because no symptoms related to direct CCFs developed. Follow-up angiography revealed spontaneous healing of both direct CCFs. Close observation rather than emergent treatment may represent another option for direct CCF by selective navigation during the endovascular procedure.

scholarly journals Lymphoblastic Leukaemia Presenting as a Carotid-Cavernous Fistula

2013 ◽  
Vol 26 (1) ◽  
pp. 94-96
Author(s):  
V. Bagga ◽  
S. Yapa ◽  
I. Craven ◽  
C. Romanowski ◽  
D. Jellinek
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Endovascular Embolization ◽  
Interesting Case ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Cavernous Sinus Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Carotid Arterial

A carotid-cavernous fistula is a life-threatening condition characterised by an abnormal communication between the carotid arterial vessels and the cavernous venous system. Although these fistulae can arise spontaneously, they mainly occur after trauma, especially road traffic accidents, falls and penetrating cranial or orbital injuries. The mainstay of treatment involves endovascular embolization, but in those patients where this is not possible or where embolization fails, direct surgical intervention and ligation of the artery may be necessary. Here we describe an interesting case of a suspected carotid-cavernous fistula which turned out to be cavernous sinus syndrome secondary to lymphoma.

scholarly journals Hemorrhagic direct traumatic carotid-cavernous fistula during endoscopic transsphenoidal surgery: intraoperative management and endovascular treatment

2020 ◽  
Vol 2 (2) ◽  
pp. V1 ◽  
Author(s):  
Giulia Cossu ◽  
Tyler Atkins ◽  
Steven D. Hajdu ◽  
Francesco Puccinelli ◽  
Roy T. Daniel ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Transsphenoidal Surgery ◽  
Rare Complication ◽  
Mechanical Compression ◽  
Carotid Cavernous Fistula ◽  
Endoscopic Transsphenoidal Surgery ◽  
Cavernous Fistula ◽  
Intraoperative Management ◽  
Life Threatening ◽  
Arterial Patency

Carotid-cavernous fistula (CCF) is a rare complication after transsphenoidal surgery with only 10 cases published (Ahuja et al., 1992; Cinar et al., 2013; Cossu et al., 2020; Dolenc et al., 1999; Kalia et al., 2009; Karaman et al., 2009; Kocer et al., 2002; Koitschev et al., 2006; Pigott et al., 1989; Takahashi et al., 1969). Intraoperative findings vary from unrecognized events to life-threatening hemorrhages.We provide a description of the management of an acute CCF occurring during sphenoidotomy in a patient with pituitary apoplexy. Osteotomy performed in the rostrum resulted in a fracture, which extended toward the intracavernous carotid artery.Bleeding was managed with mechanical compression. Endovascular treatment allowed closure of the fistula through transarterial coiling and glue. Arterial patency was preserved and the patient had no new neurological deficit.Drilling should be considered over osteotomy for the anterior sphenoidotomy.The video can be found here: https://youtu.be/0Me23xIVeNI.

scholarly journals Traumatic Orbital Apex Syndrome: An Uncommon Sequela of Facial Trauma

2019 ◽  
Vol 98 (10) ◽  
pp. 609-612 ◽  
Author(s):  
Tom Shokri ◽  
Brad E. Zacharia ◽  
Jessyka G. Lighthall
Keyword(s):  
Facial Trauma ◽  
Direct Compression ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Superior Orbital Fissure ◽  
Superior Orbital Fissure Syndrome ◽  
Craniomaxillofacial Trauma ◽  
Direct Nerve ◽  
Displaced Fracture ◽  
Superior Orbit

Orbital apex syndrome (OAS) is a rare ocular complication following craniomaxillofacial trauma. This traumatic syndrome is a combination of features seen in both superior orbital fissure syndrome and traumatic orbital neuropathy due to nerve impingement. Due in part to the rarity of this disorder, the optimal treatment of traumatic OAS has yet to be determined. We present a case in which traumatic OAS was caused by direct compression due to a displaced fracture segment from the superior orbit. The patient was successfully treated with a combination of emergent decompression and urgent reconstruction suggesting that this may be an effective strategy in OAS resulting from direct nerve compression as a result of craniomaxillofacial fracture.

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