Post-traumatic Right Carotid-cavernous Fistula Resulting in Symptoms in the Contralateral Eye: a Case Report and Literature Review

Overview

Journal BMC Ophthalmol

Publisher Biomed Central

Specialty Ophthalmology

Date 2018 Jul 27

PMID 30045703

Citations 13

Authors

Linxin Zhu

Bing Liu

Jingxiang Zhong

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Complex Indirect Carotid-Cavernous Fistula With Contralateral Ophthalmic Manifestations.

Mohammad Razali A, Sobri M, Fuad M, Abdul Rashid A, Md Noh M Cureus. 2024; 16(11):e73670.

PMID: 39677153 PMC: 11645732. DOI: 10.7759/cureus.73670.

Neuro-Ophthalmic Manifestations of Carotid Cavernous Fistulas: A Systematic Review and Meta-Analysis.

Al-Shalchy A, Al-Wassiti A, Hashim M, Al-Khazaali Y, Talib S, Bani-Saad A Cureus. 2024; 16(7):e65821.

PMID: 39219909 PMC: 11363009. DOI: 10.7759/cureus.65821.

Traumatic Carotid Cavernous Fistula Resulting in Symptoms in the Ipsilateral Eye: A Case Report.

Saleem M, Yadlapalli S, Jamil S, Mekowulu F, Saad M, Sadiq A Cureus. 2022; 14(10):e30950.

PMID: 36465727 PMC: 9713065. DOI: 10.7759/cureus.30950.

Carotid-cavernous fistula masquerading as thyroid associated orbitopathy: a diagnostic challenge.

Agrawal M, Kumari L, Vichare N, Shyamsundar K, Avasthi A, Gupta S Rom J Ophthalmol. 2022; 66(2):168-172.

PMID: 35935074 PMC: 9289768. DOI: 10.22336/rjo.2022.33.

Contralateral traumatic carotid cavernous fistula after a craniomaxillofacial fracture.

Elmrini S, Razem B, Annour M, Raiteb M, El Hamid S, Baladi O Ann Med Surg (Lond). 2021; 69:102761.

PMID: 34484730 PMC: 8405905. DOI: 10.1016/j.amsu.2021.102761.

References

Parkinson D . Lateral sellar compartment: history and anatomy. J Craniofac Surg. 1995; 6(1):55-68. DOI: 10.1097/00001665-199501000-00016. View

Celik O, Buyuktas D, Islak C, Sarici A, Gundogdu A . The association of carotid cavernous fistula with Graves' ophthalmopathy. Indian J Ophthalmol. 2013; 61(7):349-51. PMC: 3759106. DOI: 10.4103/0301-4738.109533. View

Liang W, Xiaofeng Y, Weiguo L, Wusi Q, Gang S, Xuesheng Z . Traumatic carotid cavernous fistula accompanying basilar skull fracture: a study on the incidence of traumatic carotid cavernous fistula in the patients with basilar skull fracture and the prognostic analysis about traumatic carotid cavernous fistula. J Trauma. 2007; 63(5):1014-20. DOI: 10.1097/TA.0b013e318154c9fb. View

Ellis J, Goldstein H, Connolly Jr E, Meyers P . Carotid-cavernous fistulas. Neurosurg Focus. 2012; 32(5):E9. DOI: 10.3171/2012.2.FOCUS1223. View

Barrow D, Spector R, Braun I, Landman J, Tindall S, TINDALL G . Classification and treatment of spontaneous carotid-cavernous sinus fistulas. J Neurosurg. 1985; 62(2):248-56. DOI: 10.3171/jns.1985.62.2.0248. View

Wang Y, Zhong Y, Ma J, Yang N, Wang K, Jiang Y . [Clinical features of carotid-cavernous sinus fistulas in 23 patients]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2014; 36(2):158-63. DOI: 10.3881/j.issn.1000-503X.2014.02.008. View

Gemmete J, Chaudhary N, Pandey A, Ansari S . Treatment of carotid cavernous fistulas. Curr Treat Options Neurol. 2010; 12(1):43-53. DOI: 10.1007/s11940-009-0051-3. View

Ringer A, Salud L, Tomsick T . Carotid cavernous fistulas: anatomy, classification, and treatment. Neurosurg Clin N Am. 2005; 16(2):279-95, viii. DOI: 10.1016/j.nec.2004.08.004. View

Thinda S, Melson M, Kuchtey R . Worsening angle closure glaucoma and choroidal detachments subsequent to closure of a carotid cavernous fistula. BMC Ophthalmol. 2012; 12:28. PMC: 3412712. DOI: 10.1186/1471-2415-12-28. View

10.

Debrun G, Vinuela F, Fox A, Davis K, Ahn H . Indications for treatment and classification of 132 carotid-cavernous fistulas. Neurosurgery. 1988; 22(2):285-9. DOI: 10.1227/00006123-198802000-00001. View

11.

Leishangthem L, Satti S . Indirect carotid cavernous fistula mimicking ocular myasthenia. BMJ Case Rep. 2017; 2017. PMC: 5665180. DOI: 10.1136/bcr-2017-222048. View

12.

Fattahi T, Brandt M, Jenkins W, Steinberg B . Traumatic carotid-cavernous fistula: pathophysiology and treatment. J Craniofac Surg. 2003; 14(2):240-6. DOI: 10.1097/00001665-200303000-00020. View

13.

Higashida R, Hieshima G, Halbach V, Bentson J, Goto K . Closure of carotid cavernous sinus fistulae by external compression of the carotid artery and jugular vein. Acta Radiol Suppl. 1986; 369:580-3. View

14.

Miller N . Diagnosis and management of dural carotid-cavernous sinus fistulas. Neurosurg Focus. 2007; 23(5):E13. DOI: 10.3171/FOC-07/11/E13. View

15.

De Blasi R, dUrso P, Colamaria A, Occhiogrosso G, Ciappetta P . Spontaneous carotid-cavernous fistula supplied by the contralateral meningohypophyseal trunk: case report and literature review. J Neurosurg Sci. 2010; 54(1):45-8. View

16.

Lore F, Polito E, Cerase A, Bracco S, Loffredo A, Pichierri P . Carotid cavernous fistula in a patient with Graves' ophthalmopathy. J Clin Endocrinol Metab. 2003; 88(8):3487-90. DOI: 10.1210/jc.2003-030272. View

17.

Chaudhry I, Elkhamry S, Al-Rashed W, Bosley T . Carotid cavernous fistula: ophthalmological implications. Middle East Afr J Ophthalmol. 2010; 16(2):57-63. PMC: 2813585. DOI: 10.4103/0974-9233.53862. View

18.

Zanaty M, Chalouhi N, Tjoumakaris S, Hasan D, Rosenwasser R, Jabbour P . Endovascular treatment of carotid-cavernous fistulas. Neurosurg Clin N Am. 2014; 25(3):551-63. DOI: 10.1016/j.nec.2014.04.011. View