Case Report

Approach To a Case With Carotid-Cavernous Fistula - Case Report

  • Sülay Eraslan Özdil
  • Yelda Buyru Özkurt
  • Aysu Karatay Arsan
  • Onur Karadag

Received Date: 25.06.2008 Accepted Date: 13.08.2008 Turk J Ophthalmol 2008;38(6):528-532

A 44 year old female patient was admitted to Dr.Lutfi Kirdar Kartal Training and Research Hospital's 1st Ophthalmology Clinic complaining of progressively increasing pain, redness and enlargement of the eye. On initial ophthalmic examination, corrected visual acuity was 0.3 in the right and 1.0 in the left eye. Biomicroscopic examination revealed the right eyelid edema, conjunctival hiperemia and chemosis, proptosis, fixed dilated pupil, (-) light reflex in the right eye while the left eye was normal. Fundus examination of the right eye showed obvious venous dilatation and increased tortuosity, arterial narrowing and flame shaped preretinal haemorrhages and the left eye was normal. Intraocular pressure with applanation tonometer was measured as 34 mmHg in the right and 16 mmHg in the left eye. Following the detailed eye examination, orbital color doppler imaging, contrasted and non-contrasted computerized axial orbital tomography, cranial magnetic resonance imaging, magnetic resonance angiography and digital substract angiography (DSA) were applied to the patient. As a result of these radiological tests, the patient was diagnosed as carotid-cavernous fistula (CCF). After that, cavernous sinus was occluded by placing silicone balloon. After a week, an obvious improvement was noticed in the eye exam. No matter what the etiologic cause for CCF is, its serious complications can be prevented and visual rehabilitation can be obtained with early diagnosis and treatment.

Keywords: Carotid-cavernous fistula, embolisation

Full Text (Turkish)