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A Case of Spontaneous Bilateral Direct Carotid-Cavernous Fistula

A 92-year-old female with poorly controlled systemic hypertension presented with bilateral eye redness, lid fullness, conjunctival chemosis, ophthalmoplegia, and ptosis for two days. A neuro-ophthalmic evaluation revealed bilateral proptosis, severe conjunctival chemosis and congestion, and an almos...

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Autores principales: Pellegrini, Francesco, Zappacosta, Antonio, Cirone, Daniele, Ciabattoni, Cristina, Lee, Andrew G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9152301/
https://www.ncbi.nlm.nih.gov/pubmed/35664394
http://dx.doi.org/10.7759/cureus.24634
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author Pellegrini, Francesco
Zappacosta, Antonio
Cirone, Daniele
Ciabattoni, Cristina
Lee, Andrew G
author_facet Pellegrini, Francesco
Zappacosta, Antonio
Cirone, Daniele
Ciabattoni, Cristina
Lee, Andrew G
author_sort Pellegrini, Francesco
collection PubMed
description A 92-year-old female with poorly controlled systemic hypertension presented with bilateral eye redness, lid fullness, conjunctival chemosis, ophthalmoplegia, and ptosis for two days. A neuro-ophthalmic evaluation revealed bilateral proptosis, severe conjunctival chemosis and congestion, and an almost complete bilateral ophthalmoplegia with a complete right superior eyelid ptosis. Computed tomography (CT) scans demonstrated bilateral dilation of the superior ophthalmic veins, and a CT angiography (CTA) showed a direct high-flow carotid-cavernous fistula (CCF) with secondary extraocular muscle enlargement. Clinicians should be aware that a typical direct high-flow CCF, although usually occurs after trauma and unilaterally, can present spontaneously without trauma and bilaterally.
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spelling pubmed-91523012022-06-02 A Case of Spontaneous Bilateral Direct Carotid-Cavernous Fistula Pellegrini, Francesco Zappacosta, Antonio Cirone, Daniele Ciabattoni, Cristina Lee, Andrew G Cureus Neurology A 92-year-old female with poorly controlled systemic hypertension presented with bilateral eye redness, lid fullness, conjunctival chemosis, ophthalmoplegia, and ptosis for two days. A neuro-ophthalmic evaluation revealed bilateral proptosis, severe conjunctival chemosis and congestion, and an almost complete bilateral ophthalmoplegia with a complete right superior eyelid ptosis. Computed tomography (CT) scans demonstrated bilateral dilation of the superior ophthalmic veins, and a CT angiography (CTA) showed a direct high-flow carotid-cavernous fistula (CCF) with secondary extraocular muscle enlargement. Clinicians should be aware that a typical direct high-flow CCF, although usually occurs after trauma and unilaterally, can present spontaneously without trauma and bilaterally. Cureus 2022-04-30 /pmc/articles/PMC9152301/ /pubmed/35664394 http://dx.doi.org/10.7759/cureus.24634 Text en Copyright © 2022, Pellegrini et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurology
Pellegrini, Francesco
Zappacosta, Antonio
Cirone, Daniele
Ciabattoni, Cristina
Lee, Andrew G
A Case of Spontaneous Bilateral Direct Carotid-Cavernous Fistula
title A Case of Spontaneous Bilateral Direct Carotid-Cavernous Fistula
title_full A Case of Spontaneous Bilateral Direct Carotid-Cavernous Fistula
title_fullStr A Case of Spontaneous Bilateral Direct Carotid-Cavernous Fistula
title_full_unstemmed A Case of Spontaneous Bilateral Direct Carotid-Cavernous Fistula
title_short A Case of Spontaneous Bilateral Direct Carotid-Cavernous Fistula
title_sort case of spontaneous bilateral direct carotid-cavernous fistula
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9152301/
https://www.ncbi.nlm.nih.gov/pubmed/35664394
http://dx.doi.org/10.7759/cureus.24634
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