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Post-traumatic carotid-cavernous fistula with bilateral proptosis simulating cavernous sinus thrombosis
Nirupama Kasturi1, Pooja Kumari1, Gayatri Nagarajan1
1Ophthalmology, JIPMER, Puducherry, India.
Abstract:
A 48-year-old woman presented with bilateral non-pulsatile proptosis and ophthalmoplegia after 3 days following blunt orbital trauma. It was associated with fever, malaise and loss of vision in right eye. She was provisionally diagnosed with cavernous sinus thrombosis and was treated with intravenous antibiotics with no improvement. A subtle bruit was present on examination, and digital subtraction angiography revealed a right direct (type A) carotid-cavernous fistula (CCF). The patient underwent right coil embolisation of direct CCF. On follow-up at 4 months, her proptosis resolved completely and extraocular movements improved.
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