Reversal of blindness after transvenous embolization of a carotid-cavernous fistula: Case report

Felipe C. Albuquerque, Grant W. Heinz, Cameron G. McDougall, Robert H. Rosenwasser, Bernard Bendok, L. Nelson Hopkins, Gary K. Steinberg, Steven C. Zielinski, Randall T. Higashida

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

OBJECTIVE AND IMPORTANCE: Reversal of blindness after the endovascular treatment of a carotid-cavernous fistula (CCF) is exceedingly rare. It has been reported only once in a patient with a direct CCF. We report the first such case in a patient with an indirect CCF. Defining patients whose vision may recover is critical in coordinating the timing of therapy. Mechanisms of reversible visual loss in CCFs are discussed with the intent of elucidating the patients who compose this subgroup. CLINICAL PRESENTATION: A 65-year-old man had a 1 -week history of blindness, chemosis, and proptosis of the right eye. Ophthalmoscopy was compromised by diffuse choroidal effusion and corneal edema that obscured visualization of the patient's retina. INTERVENTION: Transvenous embolization through retrograde catheterization of the superior ophthalmic vein allowed complete coil occlusion of the lesion. The patient's visual loss improved rapidly, returning to normal within 50 days. CONCLUSION: Although CCFs frequently are associated with permanent visual loss, a subset of patients demonstrates reversible ocular findings. If the retina of a patient with a CCF seems normal or is obscured, the potential for visual recovery, even from blindness, should prompt emergent treatment.

Original languageEnglish (US)
Pages (from-to)233-237
Number of pages5
JournalNeurosurgery
Volume52
Issue number1
DOIs
StatePublished - Jan 1 2003
Externally publishedYes

Fingerprint

Blindness
Fistula
Retina
Corneal Edema
Ophthalmoscopy
Exophthalmos
Catheterization
Veins
Therapeutics

Keywords

  • Blindness
  • Carotid-cavernous fistula
  • Transvenous embolization

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Albuquerque, F. C., Heinz, G. W., McDougall, C. G., Rosenwasser, R. H., Bendok, B., Hopkins, L. N., ... Higashida, R. T. (2003). Reversal of blindness after transvenous embolization of a carotid-cavernous fistula: Case report. Neurosurgery, 52(1), 233-237. https://doi.org/10.1097/00006123-200301000-00031

Reversal of blindness after transvenous embolization of a carotid-cavernous fistula : Case report. / Albuquerque, Felipe C.; Heinz, Grant W.; McDougall, Cameron G.; Rosenwasser, Robert H.; Bendok, Bernard; Hopkins, L. Nelson; Steinberg, Gary K.; Zielinski, Steven C.; Higashida, Randall T.

In: Neurosurgery, Vol. 52, No. 1, 01.01.2003, p. 233-237.

Research output: Contribution to journalArticle

Albuquerque, FC, Heinz, GW, McDougall, CG, Rosenwasser, RH, Bendok, B, Hopkins, LN, Steinberg, GK, Zielinski, SC & Higashida, RT 2003, 'Reversal of blindness after transvenous embolization of a carotid-cavernous fistula: Case report', Neurosurgery, vol. 52, no. 1, pp. 233-237. https://doi.org/10.1097/00006123-200301000-00031
Albuquerque, Felipe C. ; Heinz, Grant W. ; McDougall, Cameron G. ; Rosenwasser, Robert H. ; Bendok, Bernard ; Hopkins, L. Nelson ; Steinberg, Gary K. ; Zielinski, Steven C. ; Higashida, Randall T. / Reversal of blindness after transvenous embolization of a carotid-cavernous fistula : Case report. In: Neurosurgery. 2003 ; Vol. 52, No. 1. pp. 233-237.
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