A Case of Right-Sided Direct Carotid Cavernous Fistula: A Diagnostic Challenge
Loading...
Files
Authors
Latt, Htun
Kyaw, Kyaw
Yin, Htwe Htwe
Kapoor, Deepak
Aung, Sammy
Islam, Raheel
Issue Date
2018
Type
Article
Language
Keywords
Carotid-Cavernous Sinus Fistula , Endovascular Procedures , Exophthalmos , Orbital Cellulitis
Alternative Title
Abstract
Rare disease/diagnostic challenge Background: Carotid cavernous fistulas (CCFs) are rare potentially sight-threatening abnormal connections between carotid artery and cavernous sinus. Case Report: We report a case of CCF in an 83-year-old female, who presented with swollen and painful right eye. The patient was initially treated with empiric antibiotics for suspected peri-orbital cellulitis, as noted clinically and in computed tomography (CT) orbits. However, lack of clinical improvement, physical finding of orbital bruit/thrill, and enlarged superior ophthalmic vein in magnetic resonance (MR) orbits suggest alternate diagnoses. Eventually, CT angiogram (CTA) and carotid-arteriography confirmed the diagnosis of right-sided direct CCF, which was subsequently treated with endovascular embolization. Not only does this case highlight the importance of CCF, which could be a differential diagnosis of swollen red eye, it also addresses the vital importance of physical examination in modern medicine despite the seemingly promising technologies. Conclusions: Internists should have a low threshold of clinical suspicion for CCF in a patient with swollen red eyes in order to provide timely and proper management.
Description
Citation
Latt, H., Kyaw, K., Yin, H. H., Kapoor, D., Aung, S. S. M., & Islam, R. (2018). A Case of Right-Sided Direct Carotid Cavernous Fistula: A Diagnostic Challenge. American Journal of Case Reports, 19, 47–51. doi:10.12659/ajcr.907291
Publisher
Journal
Volume
Issue
PubMed ID
ISSN
1941-5923