Abstract

ZAMBRANO-URBANO, José Leonel et al. An unusual presentation of carotid-cavernosa fistula secondary to mild craneoenephalic trauma: a case report. Medicas UIS [online]. 2022, vol.35, n.2, e504.  Epub Dec 03, 2022. ISSN 0121-0319.  https://doi.org/10.18273/revmed.v35n2-2022011.

The carotid-cavernous fistula is any abnormal communication between the carotid artery and the cavernous sinus, generating a pathological arteriovenous shunt manifesting anterograde to the orbit, causing blindness and ophthalmoparesis. Its association with mild head trauma is scarce and underreported, its prevalence being unknown. A 54-year-old male patient from Cali - Colombia is reported, with a history of mild cranioencephalic trauma 2 months ago, who consulted for a holocranial headache and visual disturbances. On physical examination he presented ophthalmoparesis, with bilateral asymmetric palpebral ptosis with left pulsatile proptosis. A simple brain magnetic resonance and angio-MRI was performed, with findings suggestive of a carotid-cavernous fistula. The patient was taken to arteriography plus embolization, achieving a favorable result. The presence of headache with red flags, visual disturbances, pulsatile proptosis, and a history of head trauma, regardless of its degree, can lead to suspect the presence of this entity.

Keywords : Ophthalmoplegia; Exophtalhmos; Carotid-Cavernous Sinus Fistula; Traumatic Brain Injury.

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