Direct carotid-cavernous sinus fistula

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Identifier EEC-ChronicdirectCCF-NOVEL
Title Direct carotid-cavernous sinus fistula
Subject carotid-cavernous sinus fistula, arteriovenous fistula, vascular disease, elevated episcleral venous pressure
Creator Jonathan A. Micieli, MD, Department of Ophthalmology, Emory University School of Medicine, Valérie Biousse, MD Departments of Ophthalmology and Neurology, Emory University School of Medicine
Description A 40-year-old man presented with decreased vision and redness in his left eye. He had a significant trauma to the left side of his face about one year ago, but did not seek medical attention. External examination showed significant proptosis of the left eye (Figure 1) and conjunctival injection and corkscrew episcleral vessels (Figure 2). Ocular motility was full in both eyes (Figure 3) and dilated examination showed left optic disc pallor, tortuous venules, and attenuated arterioles (Figure 4). CT scan of the orbits showed left proptosis (Figure 5), enlarged cavernous sinuses, superior ophthalmic veins, and extraocular muscles on the left (Figure 6). Similar findings were seen on coronal (Figure 7) and sagittal slices (Figure 8). A catheter angiogram was performed and showed evidence of Borden type II direct left carotid-cavernous sinus fistula shunting into bilateral cavernous sinuses (Figure 9). He was treated with transarterial coil embolization (Figure 10) and post-coiling catheter angiogram showed complete obliteration of the carotid cavernous sinus fistula without residual arteriovenous shunting (Figures 11 and 12).
Publisher Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E, SLC, UT 84112-5890
Date 2018-01
Format application/pdf
Rights Management Copyright 2018. For further information regarding the rights to this collection, please visit:
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s62r7pz6
Setname ehsl_novel_eec
Date Created 2018-01-17
Date Modified 2018-02-20
ID 1292361
Reference URL
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