Carotid-cavernous Fistula in a Patient with Minimal Head and Facial Trauma: A Case Report
Published Web Location
https://doi.org/10.5811/cpcem.48556
Abstract
Introduction: Intracranial arterial injury is typically associated with high-energy trauma. Early diagnosis and treatment are essential for improving patients' functional prognosis.
Case Presentation: A 76-year-old woman complained of pulsatile tinnitus on the 15th day after her traffic accident, in which she got injured only a bruise to her face, while severe injuries to her torso. On the 17th day, ptosis, conjunctival congestion, and an ocular motility disorder developed in her right eye. Magnetic resonance angiography showed a direct high-flow shunt from the internal carotid artery to the cavernous sinus. On the 20th day, the same symptoms developed in her left eye. On the 23rd day, coil embolization to the fistula reduced symptoms in the left eye, but not the right eye.
Discussion: This complication rarely occurs in patients with head trauma. Our case indicates that this can occur even in patients without obvious head or facial trauma, and even in the subacute phase of trauma care.