Carotidcavernousfistula complicated by contralateral abducens palsy and optic neuropathy. Carotid-cavernousfistulas (CCFs) occur rarely in children. We present the second known case of a pediatric CCF complicated by contralateral cranial nerve palsies. A 9-year-old boy developed a left CCF after falling onto a plastic stick. He underwent stenting of the internal carotid artery and transvenous
Embolization of indirect carotidcavernousfistulas via the vein of Labbé using contralateral approach. In our report, we present the case of a 60-year-old adult with symptomatic indirect carotid-cavernousfistulas (CCFs). All venous outflow routes from the cavernous sinus were absent except for an engorged left superficial middle cerebral vein, which extended through the left vein of Labbé
Robotic-guided direct transtemporal embolization of an indirect carotidcavernousfistula. A middle-aged patient presented with right-sided chemosis, exophthalmos, and progressive visual loss. Digital subtraction angiography revealed a type D carotid-cavernousfistula (CCF). Transarterial embolization through the internal maxillary artery was unsuccessful, and there was no venous access
Republished:Aspiration catheter failure leading to carotid-cavernousfistula during stroke thrombectomy. Endovascular thrombectomy in acute ischaemic stroke commonly uses aspiration catheters, either alone or in combination with stent retrievers. The Penumbra Aspiration System (Penumbra, Alameda, California, USA) was first approved by the US Food and Drug Administration in 2007, with low reported device-related complications. We present a case of a previously unreported complication related to malfunction of a Penumbra aspiration catheter during stroke thrombectomy resulting in a carotid-cavernousfistula.
Diagnostic clues of IOP pulsation on applanation tonometry in carotid-cavernousfistula patients. Carotid-cavernousfistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system and exhibits typical symptoms of red eye, diplopia, blurred vision, headache, and murmur. However, the symptoms for CCF may vary and can lead to misdiagnosis. IOP pulsations
Direct puncture of the superior ophthalmic vein for carotidcavernousfistulas: a 21-year experience. Direct puncture of the superior ophthalmic vein (SOV) is an alternative approach to traversing the inferior petrosal sinus for embolization of carotidcavernousfistulas (CCFs). To analyze direct SOV puncture for the treatment of CCFs and review the literature. All patients at a single center
Republished: Successful treatment of direct carotid-cavernousfistula in a patient with Ehlers-Danlos syndrome type IV without arterial puncture: the transvenous triple-overlay embolization (TAILOREd) technique. We report successful transvenous treatment of direct carotid-cavernousfistula in a patient with Ehlers-Danlos syndrome type IV using a novel triple-overlay embolization (TAILOREd
Intraocular Pressure in the Eyes of Patients With Carotid-CavernousFistulas: Profile, Intereye Asymmetry, and Treatment Outcomes. Secondary ocular hypertension (OHT) is common in carotid-cavernousfistulas (CCFs). Management of elevated intraocular pressure (IOP) is possible with a multidisciplinary approach. The ipsilateral normal eyes may have higher IOP than the contralateral eyes. To study
Carotid-cavernousfistula(CCF) presenting as paroxysmal painful ophthalmoplegia. Painful ophthalmoplegia can be caused by various etiologies, and broad differential diagnosis is needed. Carotid-cavernousfistula (CCF) is a rare cause of painful ophthalmoplegia, and early diagnosis is quite difficult. Here, we present a case of paroxysmal painful ophthalmoplegia caused by CCF. The episodic or remitting during an early stage of CCF and that posterior-draining CCF is prone to misdiagnosis due to atypical manifestations. Normal CTA results cannot exclude carotid-cavernousfistula, and DSA should be performed once CCF is suspected.
Retinal And Choroidal Optical Coherence Tomography Findings Of CarotidCavernousFistula. To define the retinal and choroidal imaging findings of carotidcavernousfistula (CCF) including central foveal thickness, subfoveal choroidal thickness, choroidal vascularity index (CVI) parameters, and tortuosity indexes (TIs) as compared to a control group (CG). Cross-sectional study. The spectral
CarotidCavernousFistula Mimicking Hemicrania Continua: A Case Report. Hemicrania continua is a primary headache disorder characterized by a continuous, unilateral headache associated with ipsilateral cranial autonomic features that responds to indomethacin. By definition, the symptoms are not referable to an underlying structural pathology. However, several cases of secondary hemicrania continua related to underlying structural lesions have been reported. We present a case of a 53-year-old male with a prolonged, right-sided headache associated with intermittent right-sided ptosis, conjunctival injection, tearing, and nasal congestion, suggestive of hemicrania continua, who was found to have an indirect carotid-cavernousfistula, and who, after endovascular treatment of the fistula, had
Gamma knife radiosurgery as an alternative treatment of Barrow type B carotidcavernousfistulas: A case report. Barrow type B carotid-cavernousfistulas are dural shunts between the meningeal branches of the internal carotid artery and the cavernous sinus; these types of dural fistulas can produce specific patterns of symptoms based on the pattern of venous drainage. A 67-year-old man came to our hospital presenting with acute left orbital pain and double vision in the left eye. The diagnosis was carotid-cavernousfistula fed by the meningohypophyseal trunk and drained to the left superior ophthalmic vein. We planned gamma knife radiosurgery for the left cavernous sinus including fistula point as an alternative treatment. The orbital pain disappeared in 2 weeks, and all signs
Flow diverters as a scaffold for treating direct carotidcavernousfistulas. Direct carotid-cavernous sinus fistulas (dCCFs) are high flow arteriovenous shunts between the internal carotid artery and the cavernous sinus. Recently, we have used the pipeline embolization device (PED) to treat dCCFs. We describe our experience treating patients with dCCFs in whom the PED was placed as the primary
Concomitant occurrence of clinoid and cavernous segment aneurysms complicated with carotidcavernousfistula: A case report. Dual aneurysms arising from the internal cerotic artery (ICA) is a very rare occurrence. Clinoid segment aneurysms (CSAs) are often seen at the carotid dural rings while cavernous carotid aneurysms (CCAs) are often a direct communication between the ICA and the cavernous sinus (CS). We present a case of complex concomitant occurrence of a CSA and a CCA complicated with delay aneurysmal rupture (DAR) resulting in carotidcavernousfistula (CCF) after our initial treatment of the patient with pipeline embolization devices (PLEDs) PATIENT CONCERNS:: We present a 64-year old female who we admitted at our institution due to one-year history of double vision. Neurological
A red eye induced by a spontaneous carotidcavernousfistula. A 73-year-old woman initially presented to our ophthalmology department with complaint of a red eye with gradual proptosis and mild restricted movement of the right eye who was misdiagnosed with conjunctivitis during 2 months. One week later she returned to the emergency department with a painful, swollen right eye and a high superior ophthalmic vein (SOV). In view of her persistent elevated IOP despite maximum medications and dilated conjunctival veins, she was advised digital subtraction angiography (DSA) and imaging revealed a carotidcavernousfistula (CCF). The purpose of this article is to describe ophthalmological complaints of CCFs to help ophthalmologist in understanding the clinical features of spontaneous CCF
Post-traumatic right carotid-cavernousfistula resulting in symptoms in the contralateral eye: a case report and literature review. To report a case of a carotid-cavernousfistula (CCF) that occurred after a motor vehicle accident and review the uniqueness of this case and the main confusing points for the diagnosis of such cases. A 22-year-old man complained of left eyelid swelling, eye redness
An Eye with a Heartbeat: CarotidCavernousFistula-a Case Report. A carotidcavernousfistula is a rare type of arteriovenous (AV) fistula due to an abnormal communication between the cavernous sinus and the carotid arterial system. Normal venous return to the cavernous sinus is impeded as high-pressure arterial blood enters the cavernous sinus. The classical triad of symptoms is characterized discuss the clinical presentation, pathophysiology, and diagnostic modalities important to the management of this rare and potentially devastating cause of vision loss. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: A carotidcavernousfistula is a rare and easily misdiagnosed cause of unilateral ocular pain in the ED. Further, it emphasizes the importance of a detailed clinical history
A Case of Right-Sided Direct CarotidCavernousFistula: A Diagnostic Challenge BACKGROUND Carotidcavernousfistulas (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
Vasospasm in the setting of traumatic bilateral carotid-cavernousfistulas and its effect on treatment Direct, Type A, cavernous-carotid fistulas (CCFs) are predominantly caused by head trauma, especially when basilar skull fractures are present. Transarterial endovascular treatment of direct CCFs is the preferred method of treatment. Bilateral CCFs are estimated to be present in 1-2