A Troublesome Case of Indirect Carotid-Cavernous Fistula Presenting with Proptosis without Pulsation

Abstract

In this case report we represent a rare case of indirect carotid cavernous fistula (CCF) in middle-age man. A 56 year-old male presented to emergency room with a history of redness, swelling in his left eye and binocular diplopia for ten days. Upon questioning, he revealed that he had complaints about his left eye ongoing for ten months but it got worse for the last ten days. he had proptosis, chemosis with engorged and dilated scleral veins, restricted extraocular movements .After Orbital CT, CT venography, DSA performed and confirmed the diagnosis of CCF. The CCF was embolized. Our case report demonstrates how CCF is a vision threatening disease that can be easily misdiagnosed, especially in indirect fistulas with more indolent symptoms and satisfying prognostic outcome can be achieved with prompt diagnosis and treatment