scholarly journals A rare case of bilateral spontaneous indirect caroticocavernous fistula treated previously as a case of conjunctivitis

2018 ◽  
Vol 10 ◽  
pp. 251584141878830
Author(s):  
Shaheryar Khan ◽  
Caspar Gibbon ◽  
Steve Johns
Keyword(s):  
Rare Case ◽  
Arterial System ◽  
Carotid Cavernous Fistula ◽  
Ehlers Danlos Syndrome ◽  
Cavernous Fistula ◽  
Bilateral Carotid ◽  
History Of ◽  
Type C ◽  
Carotid Cavernous Fistulas ◽  
Red Eyes

Carotid cavernous fistula is an abnormal communication between the carotid arterial system and the cavernous sinus. We present an interesting, rare case of bilateral spontaneous ‘Barrow type- C’ fistula treated presumptively as conjunctivitis. A 66 year old patient presented in the eye casualty at North Devon District Hospital in January 2016, referred from her General practitioner complaining of bilateral red eyes. She was found to have large, prominently diffused and engorged scleral blood vessels on both sides along with raised intraocular pressures of 26mm of Hg bilaterally. The patient was diagnosed with an indirect carotic cavernous fistulas bilaterally in view of the clinical and radiology findings. Barrow type - C dural fistulas were reported to be seen bilaterally on radiology findings. Patient was referred for interventional treatment to the closest neurosurgical center where she had four failed attempts of coil embolization after which she was referred to a second neurosurgery center at Bristol where she underwent successful coil catheterization as the treatment for her carotid cavernous fistula. Indirect carotid cavernous fistula most commonly occur spontaneously. Bilateral spontaneous indirect carotid cavernous fistula is a very rare diagnosis and and there are very few cases reported in the literature without an underlying etiology or a known cause like Ehlers -Danlos syndrome or diabetes mellitus. Bilateral spontaneous carotid cavernous fistulas are difficult to diagnose due to mild symptoms and no history of trauma. We conclude that carotid cavernous fistulas are a threat to the vision if left untreated due to delayed diagnosis. We recommend considering bilateral carotid cavernous fistula as a differential diagnosis in patients with an ongoing history of red eyes or those unresponsive to conventional topical treatment for conjunctivitis like symptoms.

scholarly journals Posttraumatic Carotid Cavernous Fistula–A Rare Case

2020 ◽  
Author(s):  
Amit Dahiya ◽  
Sumit Dahiya ◽  
Suresh Kumar S. ◽  
Shrikant V Rege ◽  
Gaurav Jatav ◽  
...  
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Rare Case ◽  
Road Traffic ◽  
Young Male ◽  
Carotid Cavernous Fistula ◽  
Av Fistula ◽  
Cavernous Fistula ◽  
History Of ◽  
Gcs Score

AbstractCarotid cavernous fistula (CCF) is a specific type of dural arteriovenous (AV) fistula characterized by abnormal AV shunting within the cavernous sinus. The authors present a case of a 17-year-old young male who encountered a road traffic accident while driving a car, with a history of flipping of cars multiple times. The patient was unconscious with symmetrical bilateral (B/L) pupils and with Glasgow coma scale (GCS) score of 3. There was no history of seizures or vomiting.

scholarly journals Low-Flow Direct Carotid-Cavernous Fistula Caused by Rupture of an Intracavernous Carotid Aneurysm

2014 ◽  
Vol 20 (4) ◽  
pp. 476-481 ◽  
Author(s):  
I-Chang Su ◽  
Juan Pablo Cruz ◽  
Timo Krings
Keyword(s):  
Rare Case ◽  
High Flow ◽  
Low Flow ◽  
Clinical Scenario ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Carotid Cavernous Fistulas ◽  
Direct Carotid Cavernous Fistula

Direct carotid-cavernous fistulas (CCFs) secondary to a ruptured intracavernous carotid aneurysm (ICCA) are usually high-flow lesions. On very rare occasions, a ruptured ICCA may present as a low-flow CCF, which poses a diagnostic and therapeutic dilemma whether the aneurysm and the observed fistula are causally related. Herein, we describe a rare case in which a ruptured ICCA resulted in a low-flow CCF. We demonstrated our approach to clarify this clinical scenario, and also propose a possible pathomechanism to explain the existence of low-flow direct CCF.

scholarly journals Spontaneous Occlusion of a Bilateral Post Traumatic Carotid Cavernous Fistula

2001 ◽  
Vol 7 (3) ◽  
pp. 245-252 ◽  
Author(s):  
A. Churojana ◽  
O. Chawalaparit ◽  
P. Chiewwit ◽  
S. Suthipongchai
Keyword(s):  
Head Injury ◽  
Spontaneous Closure ◽  
Rare Occurrence ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Spontaneous Cure ◽  
Bilateral Carotid ◽  
Post Traumatic ◽  
Partial Thrombosis ◽  
Carotid Cavernous Fistulas

This report describes a rare occurrence of spontaneous closure of direct bilateral carotid cavernous fistula in a 62-year-old woman who had head injury. This was confirmed by clinical examination and subsequent angiogram. Partial thrombosis of bilateral superior ophthalmic veins was observed in the initial arteriography. This finding may be useful in prediction of spontaneous cure of carotid cavernous fistulas.

scholarly journals Carotid Cavernous Fistula: Role of Open Surgery in The Era of Endovascular Treatment

2017 ◽  
Vol 14 (1) ◽  
pp. 36-39
Author(s):  
Rajau K Sharma ◽  
Gopal R Sharma ◽  
Prakash Bista ◽  
Rajiv Jha
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Ct Angiography ◽  
Internal Carotid ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
History Of ◽  
Displaced Fracture ◽  
Carotid Cavernous Fistulas

A 18-year-old right handed girl presented with progressive proptosis, chemosis, diplopia and an orbital bruit of right eye, 3 days after alleged history of fall from a tree, The intraocular pressure was increased. The suspected diagnosis of a direct carotid cavernous fistula (CCF) was confirmed by CT angiography CT Angiography showed direct fistulous communication of cavernous segment of right internal carotid artery with right cavernous sinus (type A right CCF) and linear minimally displaced fracture of right zygomatic arch and linear undisplaced fracture of wall of right orbit. The patient underwent right pterional craniotomy and transcavernous occlusion of fistula of right internal carotid artery (ICA). Surgery was performed with gradual resolution of the symptoms and normalization of the intraocular pressure.The pathogencsis, symptomatology, treatment of carotid cavernous fistulas are discussed.Nepal Journal of Neuroscience, Volume 14, Number 1, 2017, Page: 36-39

scholarly journals Bilateral carotid-cavernous fistula presented with unilateral symptomatology

2018 ◽  
Vol 75 (9) ◽  
pp. 940-943
Author(s):  
Milan Stojcic ◽  
Gordana Djuric ◽  
Lepsa Zoric
Keyword(s):  
Clinical Picture ◽  
Diagnostic Procedures ◽  
Arterial System ◽  
Low Flow ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Non Invasive ◽  
Bilateral Carotid ◽  
Traumatic Origin ◽  
Carotid Arterial

Introduction. Carotid-cavernous fistula presents an abnormal communication between carotid arterial system and the venous cavernous sinus. Due to anatomical characteristics of the sinus, the clinical picture is first manifested as ophthalmic problem. These fistulas are either of spontaneous or traumatic origin with different hemodynamics. They are usually on one side. However, bilateral carotidcavernous fistulas are rare and deserve special interest. Case report. We presented a 76-years-old female patient, who complained on diplopia and right eye protrusion and esotropia. Ophthalmological findings aroused suspicion of a right-side spontaneous carotid-cavernous fistula. Further non-invasive and invasive investigations confirmed our initial diagnosis. Unexpectedly, digital subtraction angiography revealed another fistula, on her left side. Both fistulas were of low flow and did not need therapy. Conclusion. Carotid- cavernous fistula represent certain diagnostic and therapeutic challenge. Although they are not indicated in a clinical picture, sometimes bilateral fistulas can be found during appropriate diagnostic procedures.

scholarly journals A brief history of carotid-cavernous fistula

2016 ◽  
Vol 126 (6) ◽  
pp. 1995-2001 ◽  
Author(s):  
Min Lang ◽  
Ghaith Habboub ◽  
Jeffrey P. Mullin ◽  
Peter A. Rasmussen
Keyword(s):  
Cavernous Sinus ◽  
Ophthalmic Artery ◽  
Artery Aneurysm ◽  
Arterial System ◽  
Vascular Lesions ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Initial Hypothesis ◽  
History Of ◽  
Carotid Arterial

Carotid-cavernous fistula was one of the first intracranial vascular lesions to be recognized. This paper focuses on the historical progression of our understanding of the condition and its symptomatology—from the initial hypothesis of ophthalmic artery aneurysm as the cause of pulsating exophthalmos to the recognition and acceptance of fistulas between the carotid arterial system and cavernous sinus as the true etiology. The authors also discuss the advancements in treatment from Benjamin Travers' early common carotid ligation and wooden compression methods to today's endovascular approaches.

Experiences with surgical thrombosis of intracranial berry aneurysms and carotid cavernous fistulas

1974 ◽  
Vol 41 (6) ◽  
pp. 657-670 ◽  
Author(s):  
Sean Mullan
Keyword(s):  
Blood Flow ◽  
Intracranial Aneurysm ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Carotid Blood Flow ◽  
Giant Intracranial Aneurysm ◽  
Surgical Methods ◽  
Carotid Cavernous Fistulas ◽  
Fine Print

✓ The results of 61 cases of stereotaxic thrombosis of intracranial berry aneurysms indicate that the technique in selected cases is comparable to, but not necessarily superior to standard surgical methods. The results of wire-induced thrombosis in 15 cases of giant intracranial aneurysm suggest that this method is effective in situations where clipping and encapsulation are inapplicable. The results of thrombosis in six cases of carotid cavernous fistula suggest that intracavernous wire thrombosis may prove to be the treatment of choice in that it seals the fistula without impairing carotid blood flow.

Deflation of metrizamide-filled balloon used to occlude a carotid-cavernous fistula

1983 ◽  
Vol 59 (3) ◽  
pp. 524-528 ◽  
Author(s):  
Thomas J. Leipzig ◽  
Sean F. Mullan
Keyword(s):  
Contrast Agent ◽  
Vascular Wall ◽  
Carotid Cavernous Fistula ◽  
Technical Problems ◽  
Content Type ◽  
Cavernous Fistula ◽  
Short Summary ◽  
Carotid Cavernous Fistulas ◽  
Fine Print

✓ A carotid-cavernous fistula was occluded by a detachable latex balloon. Because of technical problems, the contrast-filled balloon was left in a precarious position in the ostium of the fistula. Premature deflation of the balloon would have resulted in intra-arterial migration of the device. Approximately 1 week is required for the balloon to become secured in place by fibrous attachment to the vascular wall. For success, if the ligature is adequate, a detachable Debrun balloon should remain inflated for this period of time. The deflation process was monitored radiographically in this patient. The balloon remained inflated for at least 2 weeks. A short summary of the experience with deflation of various contrast-containing balloon devices in the treatment of carotid-cavernous fistulas is given. Metrizamide may be the best contrast agent for use in these devices.

scholarly journals Endovascular treatment of carotid-cavernous fistula type A with platinium coils

2008 ◽  
Vol 65 (12) ◽  
pp. 923-926 ◽  
Author(s):  
Slobodan Culafic ◽  
Robert Juszkat ◽  
Sinisa Rusovic ◽  
Dara Stefanovic ◽  
Ljubodrag Minic ◽  
...  
Keyword(s):  
Type A ◽  
Endovascular Embolization ◽  
High Flow ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Vertebrobasilar Artery ◽  
Eye Symptoms ◽  
The Right ◽  
Carotid Cavernous Fistulas ◽  
Platinum Coils

Background. Carotid-cavernous fistulas are abnormal communications between carotid arteries or their branches and the cavernous system caused mostly by trauma. Posttraumatic fistulas represent 70% of all carotid-cavernous fistulas and they are mostly high-flow shunts (type A). This type gives characteristic eye symptoms. Case report. This paper presents a 44-year old male patient with carotidcavernous fistula as a result of penetrating head injury. In clinical presentation the patient had exophthalmos, conjunctival chemosis and weakening of vision on the right eye, headache and diplopia. Digital subtracted angiography showed high-flow carotid-cavernous fistula, which was vascularised from the left carotid artery and from vertebrobasilar artery. Endovascular embolization with platinum coils was performed through the transarterial route (endoarterial approach). Check angiogram confirmed that the fistula was closed and that no new communications developed. Conclusion. Embolization of complex carotidcavernous fistula type A was successfully performed with platinum coils by endovascular approach.

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