Al-Boqami Beshayer A, Tammar Rahaf S, Alharbi Sultan E, Ahmed Zahraa M, Alharbi Ahlam
General Practice, Al-Badaya General Hospital, Al Badayea, SAU.
Medicine, King Abdulaziz University, Jeddah, SAU.
Cureus. 2023 Sep 8;15(9):e44902. doi: 10.7759/cureus.44902. eCollection 2023 Sep.
A carotid-cavernous fistula is a rare vascular anomaly involving abnormal communication between the carotid artery and the cavernous sinus. This condition leads to the shunting of arterial blood directly into the venous system, causing diverse clinical manifestations. The classification includes direct and indirect fistulas, with endovascular techniques emerging as a preferred treatment option. In this report, we present the case of a 58-year-old male who presented with progressive right-sided proptosis, headache, and visual disturbances. He exhibited right abducens nerve palsy, reduced visual acuity, and a dilated superior ophthalmic vein on imaging. A multidisciplinary team confirmed the diagnosis of a carotid-cavernous fistula and chose to pursue endovascular embolization. Catheter angiography revealed the fistula and balloon-assisted occlusion restored normal arterial flow. The patient's symptoms improved, and follow-up showed complete resolution of proptosis and enhanced visual acuity. Successful endovascular embolization underscores the significance of a multidisciplinary approach and showcases the positive outcomes achievable when diverse specialties converge for patient well-being.
颈动脉海绵窦瘘是一种罕见的血管异常，涉及颈动脉与海绵窦之间的异常连通。这种情况导致动脉血直接分流到静脉系统，引起多种临床表现。其分类包括直接瘘和间接瘘，血管内技术已成为首选的治疗方法。在本报告中，我们介绍了一名58岁男性患者的病例，该患者出现进行性右侧眼球突出、头痛和视觉障碍。他表现出右侧展神经麻痹、视力下降，影像学检查显示眼上静脉扩张。一个多学科团队确诊为颈动脉海绵窦瘘，并选择进行血管内栓塞治疗。导管血管造影显示了瘘口，球囊辅助闭塞恢复了正常动脉血流。患者症状改善，随访显示眼球突出完全消退，视力提高。成功的血管内栓塞强调了多学科方法的重要性，并展示了不同专业为患者福祉而汇聚时可取得的积极成果。
