Post-traumatic carotid-cavernous fistula with bilateral proptosis simulating cavernous sinus thrombosis | Zendy

Nirupama Kasturi | Zendy; Pooja Kumari | Zendy; Gayatri Nagarajan | Zendy; Krishnan Nagarajan | Zendy

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Post-traumatic carotid-cavernous fistula with bilateral proptosis simulating cavernous sinus thrombosis

Author(s) -

Nirupama Kasturi,

Pooja Kumari,

Gayatri Nagarajan,

Krishnan Nagarajan

Publication year - 2019

Publication title -

bmj case reports

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.231

H-Index - 26

ISSN - 1757-790X

DOI - 10.1136/bcr-2018-227757

Subject(s) - medicine , cavernous sinus , carotid cavernous fistula , ptosis , surgery , digital subtraction angiography , thrombosis , exophthalmos , cavernous sinus thrombosis , fistula , carotid cavernous sinus fistula , radiology , blunt trauma , angiography

A 48-year-old woman presented with bilateral non-pulsatile proptosis and ophthalmoplegia after 3 days following blunt orbital trauma. It was associated with fever, malaise and loss of vision in right eye. She was provisionally diagnosed with cavernous sinus thrombosis and was treated with intravenous antibiotics with no improvement. A subtle bruit was present on examination, and digital subtraction angiography revealed a right direct (type A) carotid-cavernous fistula (CCF). The patient underwent right coil embolisation of direct CCF. On follow-up at 4 months, her proptosis resolved completely and extraocular movements improved.

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