Direct carotid-cavernous fistula: an atypical presentation

Area of Science:

• Neuroscience
• Vascular Surgery
• Trauma Surgery

Background:

• Carotid-cavernous fistula (CCF) is an abnormal connection between the carotid artery and the cavernous sinus.
• Direct CCFs, often post-traumatic, typically present with acute symptoms due to high flow.
• Indirect CCFs are usually idiopathic and have an insidious onset.

Observation:

• This case report details an atypical presentation of a direct CCF.
• The patient experienced an insidious onset of symptoms, contrary to the typical acute presentation.
• This presentation mimics indirect CCFs, potentially delaying diagnosis.

Findings:

• Direct CCFs can present atypically with insidious symptoms.
• Misdiagnosis is possible due to the similarity to indirect CCFs.
• Early recognition of atypical presentations is vital for prompt intervention.

Implications:

• Increased awareness of atypical direct CCF presentations is necessary for clinicians.
• Prompt diagnosis and treatment of CCF are critical, as it is an emergency.
• This case underscores the importance of considering rare complications in craniomaxillofacial trauma.