Caroticocavernous fistula - direct

Case contributed by Dr Carlos Ruiz Badilla


Motor vehicle accident - multiple craniofacial fractures. Proptosis of right eyeball, pulsatile exophthalmos and subconjunctival hemorrhage.

Patient Data

Age: 17 years
Gender: Male

Proptosis of right eyeball, caused by 

Multiple craniofacial fractures.

DSA (angiography)
  • rapid shunting from right internal carotid artery (ICA) to cavernous sinus
  • retrograde flow from cavernous sinus to superior ophthalmic vein
  • enlarged draining veins
  • coil embolization of right ICA

Case Discussion

Before commencing with embolization, the interventional neuroradiologist verified adequate collateral circulation. He then proceeded to perform embolization of right ICA with detachable coils. The procedure concluded without complications and the patient recovered without any complications.

Procedure carried out by Dr Manuel Hernandez Gaitan, Interventional Neuroradiologist.

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Case information

rID: 61660
Published: 12th Jul 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Universidad de Costa Rica

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