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A shotgun wedding.

Leroy Ekeh1, Christopher R Dermarkarian1, Rod Foroozan1

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Summary
This summary is machine-generated.

A shotgun injury caused a rare carotid-cavernous fistula (CCF) in a 69-year-old woman. Prompt endovascular coiling successfully treated the fistula, resolving her visual symptoms.

Keywords:
AngiogramBlunt TraumaCarotid-cavernous fistulaExophthalmosGun Use

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Area of Science:

  • Ophthalmology
  • Neurosurgery
  • Trauma Surgery

Background:

  • Carotid-cavernous fistulas (CCF) are abnormal connections between the carotid artery and the cavernous sinus.
  • CCFs can result from head trauma, but shotgun-induced blunt force is an extremely rare etiology.
  • Prompt diagnosis and intervention are crucial for managing CCF and preventing visual complications.

Observation:

  • A 69-year-old female presented with visual disturbances following direct blunt force trauma from a shotgun discharge.
  • Clinical examination revealed classic signs of CCF: chemosis, proptosis, ophthalmoparesis, and conjunctival injection.
  • Initial mild visual symptoms progressed to more severe manifestations of CCF.

Findings:

  • The patient was diagnosed with a carotid-cavernous fistula secondary to shotgun blunt force trauma.
  • An intravascular coiling procedure was performed to embolize the fistula.
  • The endovascular treatment successfully occluded the CCF.

Implications:

  • This case highlights an exceptionally rare cause of CCF, emphasizing the potential for diverse traumatic etiologies.
  • It underscores the importance of considering vascular injury in patients with head trauma, even from seemingly unusual mechanisms.
  • Successful endovascular management of CCF in this context demonstrates the efficacy of modern interventional techniques for complex vascular lesions.