Open AccessPost-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 , thrombosis , exophthalmos , cavernous sinus thrombosis , surgery , fistula , carotid cavernous sinus fistula , digital subtraction angiography , radiology , 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.