[Carotid-cavernous fistula: comparison of clinical and neuroradiologic features pre- and post-embolization]

Abstract

We report the case of an 85-year-old patient, referred by her ophthalmologist for neuro-ophthalmologic consultation at the Clermont-Ferrand University Medical Center, for conjunctival hyperemia and ocular hypertension in the left eye for 12 months. The patient's only past medical history was treated, controlled arterial hypertension and there was no mention of falling or head trauma. MRI (magnetic resonance imaging) and angiography identified a type D carotid-cavernous fistula. Intravenous embolization was performed under general anesthesia by retrograde selective catheterization facial vein and ophthalmic vein and placement of coils into the cavernous sinus, resulting in regression of physical and functional signs immediately after the procedure. This case illustrates the symptoms of spontaneous carotid-cavernous fistula and immediate efficacy of embolization. We report the epidemiology, characteristics and various presentations of the condition.

Keywords: Carotid-cavernous fistula; Embolisation; Embolization; Exophtalmie; Fistule carotido-caverneuse; Hypertonie oculaire; Ocular hypertension; Proptosis.