Carotid-Cavernous fistula arising and regressing spontaneously: A case report


Uludüz D., GÜNDÜZ A. , Erkol G., Saip S.

Yeni Symposium, cilt.45, sa.1, ss.3-6, 2007 (Diğer Kurumların Hakemli Dergileri) identifier

  • Cilt numarası: 45 Konu: 1
  • Basım Tarihi: 2007
  • Dergi Adı: Yeni Symposium
  • Sayfa Sayıları: ss.3-6

Özet

Carotico-Cavernous fistulas (CCF) are abnormal communications between carotid arterial system and venous cavernous sinus that may develop spontaneously or after trauma. Spontaneous CCFs are rare and even if they tend to regress spontaneously, permanent neurological deficits are observed up to 20-30% among untreated patients. A 74 year-old female patient admitted to neurology department with a complaining of headache, and blurred vision in her left eye. Her medical history revealed hypertension for ten years. There was no history of trauma. Her neurological examination revealed redness in retina, blurred vision and restricted left eye movements. Her laboratory investigations were unremarkable. Cranial magnetic resonance imaging and angiography was performed and a spontaneous dural CCF was observed. Age, postmenopausal period, and hypertension were suggested as risk factors for CCF. After one week DSA angiography was repeated to perform embolisation however, it was noticed that the fistula was regressed spontaneously. The patient is now being followed for 18 months and has no complaint. In that regard sudden onset headache among middle aged and elderly patients should be regarded as an alarming complaint and further investigations should be performed. In patients with temporal headache, conjunctival edema and / or ophtalmoplegia, CCFs should be considered.