Spontaneous Dural Carotid-C avernous Sinus Fistula: A Case Report.
- Author:
In Taek KIM
1
;
Jeong Beom CHOI
;
Sang Min LEE
Author Information
1. Department of Ophthalmology, School of Medicine, Kyungpook National University.
- Publication Type:Case Report
- Keywords:
Carotid angiography;
Color Doppler imaging;
Dural carotid-cavernous sinus fistula;
Embolization
- MeSH:
Adult;
Angiography;
Carotid-Cavernous Sinus Fistula;
Cavernous Sinus;
Conjunctiva;
Diagnostic Errors;
Diplopia;
Estrogens, Conjugated (USP);
Exophthalmos;
Female;
Fistula*;
Humans;
Intraocular Pressure;
Muscles;
Orbit;
Thyroid Gland;
Veins;
Visual Acuity;
Visual Fields
- From:Journal of the Korean Ophthalmological Society
2000;41(3):793-800
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The case reported here, concerns a spontaneous low-flow fistula between the carotid arterial network and the cavernous sinus, with ophthalmological symptoms such as conjunctival congestion and diplopia in a 41-year-old woman. The patient has suffered from diabetes without trauma history. Patient's ocular symptoms and signs were only present in the left eye with best-corrected visual acuity 0.04 at the time of presentation. Other ophthalmic findings were exophthalmos, elevated intraocular pressure, and visual field defects. Enlarged extraocular muscles and proptosis were found on orbital computed tomography leading to the misdiagnosis of orbial pseudotumor or thyroid rbitopathy. Carotid angiography showed dural carotid-cavernous sinus fistula, which involved left-side internal and external carotid arterial network and right-side internal carotid arterial network. Orbital color Doppler imaging showed a flow reversal with a systolic component in the enlarged superior ophthalmic vein. We were able to diagnose dural carotid-cavernous sinus fistula. Dural carotid-cavernous sinus fistula was closed successfully by embolization via the vein without omplication. The visual acuity, proptosis, and dilated and tortuous vessels of the conjunctiva improved.
