DR. DHRUV GOYAL

DR. BHAGYAJYOTHI B. K., DR. UMESH HARAKUNI, DR. MITALI MANGOLI

Abstract

A carotid cavernous fistula (CCF) is an abnormality in the vascular connections between the internal carotid artery (ICA) or the external carotid artery (ECA) and the veins in the cavernous sinus. CCF is a rare anomaly that can occur spontaneously or as a result of trauma, majority of the cases being traumatic.

A 67-year-old male, presented with chief complaints of sudden onset redness and protrusion of the left eye along with drooping of the left eyelid. He gave a history of a road traffic accident (RTA) one month ago. Visual Acuity, OD was 6/9 OS was PL+ PR acc. Anterior segment examination demonstrated conjunctival chemosis, and mild ptosis with Marginal Reflex Distance (MRD) of 2.5mm. Proptosis measured was 25mm and was pulsatile in nature. On auscultation, a bruit was heard over the upper eyelid. MRI brain and orbit was done which confirmed the presence of a Type 2 CCF. He underwent OS endovascular embolization using stent via vertebral route. Within 8 hours proptosis resolved.