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Wiracakra, I Gusti Lanang Krisna
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Journal : Lombok Medical Journal

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Visual Impairment in High Flow Carotid-Cavernous Fistula: Case Report Putri, Setyawati Asih; Wiracakra, I Gusti Lanang Krisna
Lombok Medical Journal Vol. 3 No. 2 (2024): Lombok Medical Journal Volume 3 Nomor 2
Publisher : Faculty of Medicine, Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/lmj.v3i2.4499

Abstract

Carotid-cavernous fistula (CCF) is the most common abnormal connection between the carotid artery and the cavernous sinus. There are 2 types of CCF: direct and indirect. Direct CCF is a high-flow fistula that occurs due to a tear in the carotid artery, most often caused by penetrating or nonpenetrating head trauma. Visual disturbances can be one of the symptoms of CCF in post-traumatic patients. With proper diagnosis and management, the patient's condition can significantly improve. A 22-year-old man came with symptoms of bilateral chemosis and bilateral proptosis, which had developed progressively for 1 month. The patient had a history of a traffic accident 2 months before with mandibular trauma. The patient had undergone mandibular surgery, but at that time, no neurological symptoms had appeared. Physical examination revealed bilateral chemosis, bilateral proptosis, blurred vision and oftalmoplegi with diplopia. Magnetic Resonance Angiography (MRA) of the head showed features that led to a diagnosis of carotid-cavernous fistula. Cerebral angiography was performed and confirmed there was a high-flow carotid-cavernous fistula. Endovascular intervention was performed, and a decision was made to perform balloon embolization. Four months after the procedure, the patient's complaints improved, blurred vision decreased, and proptosis disappeared. Based on this case report, carotid-cavernous fistula can be used as a differential diagnosis for the cause of visual impairment in post-head trauma patients. Appropriate management can treat the patient's clinical symptoms
Co-Authors Afif, Zamroni Agistany, Nur Feby Febiana Andiyani, Dinda Zahra Putri Anggoro, Joko Annisa, Wardha Novia Briliansy, Briliansy Erwin, Ferdinand Fesmia, Herodya Lajunee Gea, Endah Irnanda Ulfa Gea, Endah Irnanda Ulfah Herpan Syafii Harahap Ilsa Hunaifi, Ilsa Indrayana, Yanna Ismiana, Baiq Holisatul Jacob, Lusye Diana kholida, Baiq Hilya Kurniawan, Theophany Margareta Landapa, Raditya Rachman Lestari, Diayanti Tenti Mayung, Claraiva Nurhidayati Nurhidayati Padauleng, Novrita Primayanti, Ika Putri, Setyawati Asih Putri, Siti Noururrifqiyati Juna Rizki, Mohammad Sapta Wardhani, Indah Setyawati, Indri Suryani, ⁠Dini Tjahyanto, Teddy Ulfa Gea, Indah Ernanda Wardi, Bq. Prita Riantiani Yohanes, Guntur