Return of vision after transarterial coiling of a carotid cavernous sinus fistula: case report

Sunit Das, Bernard Bendok, Roberta L. Novakovic, Richard J. Parkinson, Axel J. Rosengart, R. Loch Macdonald, Jeffrey I. Frank

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Carotid cavernous sinus fistulae are abnormal communications between the carotid circulation and cavernous sinus that may arise spontaneously or develop after craniocerebral trauma. They may present with a constellation of signs and symptoms characteristic of raised cavernous sinus pressure, including orbital or retro-orbital pain, pulsatile proptosis, chemosis, ocular or cranial bruit, deterioration of visual acuity, or ophthalmoplegia. Visual loss is likely the result of multiple insults to the visual system, including reversal of venous drainage from the fistula, arterial flow into the superior ophthalmic vein, increased intraocular venous pressure, venous stasis retinopathy, and eventually ischemic optic neuropathy [Brodsky MC, Hoyt WF, Halbach VV, et al. Recovery from total monocular blindness after balloon embolization of carotid-cavernous fistula. Am J Ophthalmol 1987;104:86-87; Sanders MD, Hoyt WF. Hypoxic ocular sequelae of carotid-cavernous fistulae: study of the causes of visual failure before and after neurosurgical treatment in a series of 25 cases. Br J Ophthalmol 1969;53:82-97]. Case Description: With few exceptions, the literature is replete with evidence of persistent blindness despite successful treatment of the CCF [Albuquerque FC, Heinz GW, McDougall CG. Reversal of blindness after transvenous embolization of a carotid-cavernous fistula: case report. Neurosurgery 2003;52:233-237; Brodsky MC, Hoyt WF, Halbach VV, et al. Recovery from total monocular blindness after balloon embolization of carotid-cavernous fistula. Am J Ophthalmol 1987;104:86-87; Weinstein JM, Rufenacht DA, Partington CR, et al. Delayed visual loss due to trauma of the internal carotid artery. Arch Neurol. 1991;48:490-497]. Here, we report a patient who experienced recovery of vision after endovascular obliteration of the offending CCF. Discussion: To our knowledge, this is the second reported case of recovery of visual function in a patient presenting with loss of light perception after treatment of a direct CCF.

Original languageEnglish (US)
Pages (from-to)82-85
Number of pages4
JournalSurgical Neurology
Volume66
Issue number1
DOIs
StatePublished - Jul 2006
Externally publishedYes

Fingerprint

Carotid-Cavernous Sinus Fistula
Fistula
Blindness
Balloon Occlusion
Cavernous Sinus
Ischemic Optic Neuropathy
Ophthalmoplegia
Carotid Sinus
Exophthalmos
Venous Pressure
Recovery of Function
Neurosurgery
Internal Carotid Artery
Intraocular Pressure
Craniocerebral Trauma
Visual Acuity
Signs and Symptoms
Drainage
Veins
Therapeutics

Keywords

  • Carotid cavernous fistula
  • Endovascular
  • Stenting

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Das, S., Bendok, B., Novakovic, R. L., Parkinson, R. J., Rosengart, A. J., Macdonald, R. L., & Frank, J. I. (2006). Return of vision after transarterial coiling of a carotid cavernous sinus fistula: case report. Surgical Neurology, 66(1), 82-85. https://doi.org/10.1016/j.surneu.2005.10.008

Return of vision after transarterial coiling of a carotid cavernous sinus fistula : case report. / Das, Sunit; Bendok, Bernard; Novakovic, Roberta L.; Parkinson, Richard J.; Rosengart, Axel J.; Macdonald, R. Loch; Frank, Jeffrey I.

In: Surgical Neurology, Vol. 66, No. 1, 07.2006, p. 82-85.

Research output: Contribution to journalArticle

Das, S, Bendok, B, Novakovic, RL, Parkinson, RJ, Rosengart, AJ, Macdonald, RL & Frank, JI 2006, 'Return of vision after transarterial coiling of a carotid cavernous sinus fistula: case report', Surgical Neurology, vol. 66, no. 1, pp. 82-85. https://doi.org/10.1016/j.surneu.2005.10.008
Das, Sunit ; Bendok, Bernard ; Novakovic, Roberta L. ; Parkinson, Richard J. ; Rosengart, Axel J. ; Macdonald, R. Loch ; Frank, Jeffrey I. / Return of vision after transarterial coiling of a carotid cavernous sinus fistula : case report. In: Surgical Neurology. 2006 ; Vol. 66, No. 1. pp. 82-85.
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