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Carotid–Cavernous Sinus Fistula by Revadi Govindaraju; Prepageran Narayanan is a Medicine article available to read on EtoBox.

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## Images in Clinical Medicine A healthy 18-year-old man was in a motor vehicle accident and received a head injury that resulted in intracranial bleeding at multiple sites, fractures of facial bones, and immediate traumatic mydriasis and ptosis in the left eye. Two weeks later, he had recurrent profuse epistaxis from the left side of his nose. Examination was notable for normal results of nasal endoscopy. However, in the left eye, he had complete ophthalmoplegia, ptosis (Panel A and Video), and mild exophthalmos, and vision was restricted to perception of light. The left eye showed no chemosis, pulsation, or bruit. Ophthalmologic examination of the left eye revealed traumatic optic neuropathy. Because vascular injury was suspected, computed tomographic angiography was performed, which revealed a carotid-cavernous sinus fistula and pseudoaneurysm in the fractured sphenoid sinus (Panels B and C, arrows). The patient subsequently underwent endovascular intervention, and the intracavernous internal carotid artery was successfully occluded with a detachable balloon. No further epistaxis occurred, but the neurologic deficit in the left eye remained unchanged.

Who reads Carotid–Cavernous Sinus Fistula?

Author

Revadi Govindaraju; Prepageran Narayanan

Publisher

Massachusetts Medical Society; New England Journal of Medicine; Publons (ISSN 0096-6762)

Published

2016

Language

EN

Field

Medicine (Health Sciences)