Diagnosis of carotid-cavernous fistula in ophthalmic practice (clinical case)

    Abstract

    Diagnosis of carotid-cavernous fistula in ophthalmic practice (clinical case)

    Pakhirko I.N. , Ponomareva M.N. , Ponomareva E.Yu. , Aymurzina I.A. , Samodurov A.I. , Klokov I.N.

    Regional Clinical Hospital №2, Tyumen
Tyumen State Medical University, Tyumen

    The presented clinical case demonstrates the development of ophthalmological manifestations of post-traumatic carotid-cavernous fistula on the left in patient X, born in 1995. The first signs appeared 2 days after the injury – paresis of the abducent nerve and the plethora of the venous pattern of the retinal vessels of both eyes; after 6 days, the classic picture of pulsating exophthalmos sharply developed within 5-6 hours, accompanied by atrophy of the optic nerve. Neurologists, ophthalmologists and neurosurgeons should be wary about the formation of carotid-cavernous fistula after an eye injury, for early diagnosis and timely referral to surgical endovascular treatment, before the onset of ophthalmic complications. For the diagnosis of this category of patients, it is necessary to perform a CT scan of the brain with contrast enhancement.

    Key words: carotid-cavernous fistula, computed tomography, pulsating exophthalmos