Amaurosis caused by carotid cavernous fistula after facial trauma

Victor Diniz Borborema Dos Santos, João Ferreira De Melo Neto, Petrus Pereira Gomes, José Sandro Pereira Da Silva, Adriano Rocha Germano

Carotid cavernous fistulas (CCF) are a rare complication which involves abnormal communication between the internal or external carotid artery and the cavernous sinus. Trauma is the most common etiology. This paper discusses a case of unusual presentation of CCF treated by embolization. A 35-year-old male patient was involved in a motorcycle accident with facial trauma and sought evaluation four days after trauma with amaurosis and clinical signs of CCF, that was confirmed by angiography. The patient was subjected to embolization after which he reported feeling better; however, ten days after embolization, chemosis increased. The condition was followed-up and there was no need for reintervention, since the condition remained stable and presented clinical improvement on the 15th day after embolization. At present, patient’s condition is stable, without chemosis, with vision loss on the left side, without neurological deficit, improvement in eyeball movement, and with palpebral ptosis on the left side. This paper reinforces the importance of correct clinical examination in patients subjected to trauma, paying attention to signs and symptoms of CCF and to multidisciplinary treatment, so as to minimize the consequences of CCF.

Keywords: Blindness. Carotid cavernous fistula. Therapeutic embolization.

How to cite: Santos VDB, Melo Neto JF, Gomes PP, Silva JSP, Germano AR. Amaurose provocada por fístula carótido-cavernosa após trauma facial. J Braz Coll Oral Maxillofac Surg. 2016 maio-ago;2(2):62-7. DOI: http://dx.doi.org/10.14436/2358-2782.2.2.062-067.oar

Sunday, May 05, 2024 19:36