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[Pulsating exophtalmos and contralateral carotid-cavernous fistula]
R Dulou1, L Hauret, J L Renard
1Service de neurologie, hôpital Val de Grâce, Paris, France.
Revue Neurologique
|June 20, 2002
Summary
A rare carotid-cavernous fistula presented with unusual contralateral symptoms and ipsilateral sinus thrombosis. Conservative treatment successfully resolved the condition, highlighting the importance of cavernous sinus anatomy.
Area of Science:
- Neuroscience
- Ophthalmology
- Vascular Surgery
Background:
- Spontaneous carotid-cavernous fistula (CCF) is a rare condition involving abnormal communication between the carotid artery and the cavernous sinus.
- CCF typically presents with ipsilateral symptoms such as pulsatile exophthalmos, bruit, and cranial nerve palsies.
Observation:
- This report details a rare CCF case with contralateral ocular signs, including discomfort, pulsatile exophthalmos, chemosis, and ptosis.
- The fistula was associated with partial thrombosis of the ipsilateral cavernous sinus, an uncommon co-occurrence.
Findings:
- The patient's condition, despite its unusual presentation, was successfully treated with conservative management.
- Resolution of the fistula and associated symptoms was achieved over a six-month period.
Implications:
- This case underscores the variability in CCF clinical presentation and the importance of considering contralateral signs.
- A thorough understanding of cavernous sinus anatomy is crucial for diagnosing and managing complex CCF cases.
- Conservative treatment can be effective for certain CCF presentations, challenging traditional interventional approaches.