Kurban Bushra, Mustafa Syed, Rehman Amer, Dolati Parviz
College of Medicine, Ajman University, Ajman, ARE.
Department of Medical Imaging, American Hospital Dubai (AHD), Dubai, ARE.
Cureus. 2025 Apr 25;17(4):e82996. doi: 10.7759/cureus.82996. eCollection 2025 Apr.
A carotid-cavernous fistula (CCF) is an abnormal communication between the carotid artery and the cavernous sinus. Contrary to the typical insidious onset, we present a case of an indirect CCF in a 49-year-old woman who presented with the sudden onset of a painful, swollen, and red left eye, which was initially misdiagnosed as orbital cellulitis. It is crucial to maintain a high index of suspicion in all patients who present with the sudden onset of ocular symptoms, particularly if they exhibit pulsatile proptosis, chemosis with arterialized conjunctival veins, periorbital bruit, elevated intraocular pressure (IOP), and normal inflammatory markers. Early diagnosis is essential to prevent vision loss and other associated neurological complications. The patient underwent transvenous coil occlusion of the left cavernous sinus but later developed a recurrent fistula, underscoring the need for close follow-up after endovascular intervention to detect any residual or recurrent fistula.
颈动脉海绵窦瘘（CCF）是颈动脉与海绵窦之间的异常交通。与典型的隐匿性起病不同，我们报告一例49岁女性的间接性CCF病例，该患者以左眼突发疼痛、肿胀和发红为表现，最初被误诊为眼眶蜂窝织炎。对于所有出现眼部症状突发的患者，尤其是出现搏动性眼球突出、结膜静脉呈动脉化的结膜水肿、眶周杂音、眼压升高（IOP）且炎症指标正常的患者，保持高度怀疑至关重要。早期诊断对于预防视力丧失和其他相关神经并发症至关重要。该患者接受了经静脉海绵窦栓塞术，但后来出现了复发性瘘，这突出了血管内介入治疗后密切随访以检测任何残余或复发性瘘的必要性。
