DR. LALITHA KUMARI MANUMALA

PROF.DR. (COL) K. SHYAM SUNDER, DR.(MAJ.) ABHIJEET AVASTHI, DR. DIVYA KOCHHAR

Abstract

Aim: To report a case of Carotico-Cavernous Fistula (CCF) that simulated Thyroid Associated orbitopathy (TAO)

Method: We report a case of 60 years old lady presenting with 02 weeks of left sided headache, proptosis, chemosis, esodeviation of left eye associated with pain & binocular diplopia. On investigation, Anti-TPO was 810 IU/L, MRI brain & orbits showed dilatation of all extraocular muscles. She was diagnosed as TAO & started on oral & parenteral steroids which aggravated her symptoms. CT angiography was done which showed contrast enhanced cavernous sinus and followed by DSA which revealed Left Indirect CCF. She was managed with embolization of feeder vessels which caused resolution of symptoms within 2 days.

Discussion: CCF, a rare life-threatening disorder may mimic TAO by virtue of overlapping features as seen in our case. So, patients presenting with above symptoms warrant thorough ocular & neurological evaluation & apt action will have both vision & lifesaving implicaticons.