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Traumatic carotid-cavernous fistula: A case report.
Hooman Hamedani1, Daniel Hellmann2, William Boyce1
1Kettering Health Network Diagnostic Radiology Residency, 405 W. Grand Ave, Dayton, OH 45405, USA.
Radiology Case Reports
|April 18, 2022
Summary
Direct carotid-cavernous fistulas, a rare trauma complication, can cause vision loss and require urgent treatment. This case highlights a fistula from a gunshot wound, emphasizing prompt diagnosis via angiography.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Trauma Surgery
Background:
- Direct carotid-cavernous fistulas (CCFs) are uncommon consequences of craniofacial injuries.
- These fistulas disrupt blood flow, potentially leading to critical brain and cranial nerve ischemia.
Observation:
- A middle-aged patient sustained a gunshot wound to the posterior pharynx.
- Clinical presentation included proptosis, chemosis, and other visual disturbances suggestive of CCF.
Findings:
- Imaging, including computed tomography angiography (CTA) and magnetic resonance angiography (MRA), is crucial for diagnosis.
- Digital subtraction angiography (DSA) confirmed a direct left internal carotid artery CCF in this case.
Implications:
- Prompt diagnosis and intervention are vital to prevent irreversible neurological damage.
- This case underscores the importance of considering CCF in patients with relevant trauma and visual symptoms.
