Carotid-cavernous fistula

Abstract

The carotid-cavernous fistula (CCF) is an abnormal connection between the carotid artery and the cavernous sinus that can be spontaneous in 25% of the cases or acquired in 75% of the cases, mainly with a traumatic origin. This entity is characterized for the presence of proptosis, chemosis, episcleral vessels with corkscrew appearance, eyeball pulsations, orbital bruits, decreases visual acuity and increases intraocular pressure. This paper reports the case of a 48-year-old male patient, without cranial trauma history, who had clinical data compatible with a spontaneous carotid-cavernous fistula. Initially he was treated as glaucoma and then as an orbital cellulitis with high doses of glucocorticoids not responding to treatment, being hospitalized in the department of internal medicine for having metabolic disorder. The diagnosis was confirmed by computed tomography angiography, the fistula was situated by pan-angiography and it was embolized by secondary intention using coils and Onyx™.