Differential diagnosis of the dilated superior ophthalmic vein by B-scan ultrasonography

Jørgensen, J. S.; Guthoff, Rudolf

doi:10.3109/01676838609036057

Cited by 5 publications

(2 citation statements)

References 3 publications

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“…In some cases, dilated SOV can be detected through ultrasonography [ 5 ] as seen in Case 3 (Figure 3D ). SOV dilatation detected in B-scan can be due to various pathologies such as CCF, SOV thrombosis, orbital hematoma, orbital tumors, or Grave’s disease [ 8 ]. CTA and magnetic resonance angiography (MRA) of the brain and orbit is performed to detect the presence of CCF.…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Challenges in Carotid Cavernous Fistula: A Case Series

Thiyagarajam¹,

Chong²,

Khialdin³

2021

Cureus

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A carotid-cavernous fistula (CCF) is an arteriovenous fistula with an abnormal connection between the carotid artery and cavernous sinus that can be sight and life-threatening. The conjunctival injection is often the most prominent feature, and patients are commonly misdiagnosed for other ocular conditions leading to a delay in diagnosis and treatment. All three patients in this case series presented with persistent red eyes. They were all treated for conjunctivitis and only referred for further workup when other progressing ocular symptoms occurred. The diagnosis of CCF was confirmed with digital subtraction angiography and with successful endovascular embolization, their ocular symptoms resolved with preserved optic nerve function. A high index of suspicion in patients presenting with an atypical red eye is very crucial for timely diagnosis of CCF.

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Section: Discussionmentioning

confidence: 99%

The Diagnostic Challenges in Carotid Cavernous Fistula: A Case Series

Thiyagarajam¹,

Chong²,

Khialdin³

2021

Cureus

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“…Bilateral spontaneous CCFs are difficult to diagnose due to mild symptoms and no history of trauma. B-scan ultrasound is an easy investigative tool which shows dilated superior ophthalmic veins in CCF patients; 14 – 16 hence, CCF can mostly be diagnosed easily in the smaller community hospitals or large general practices with it if the access to B-scan is available. In difficult cases where further investigation is required, MRI head scan becomes necessary as it is critical in diagnosing CCF.…”

Section: Discussionmentioning

confidence: 99%

A rare case of bilateral spontaneous indirect caroticocavernous fistula treated previously as a case of conjunctivitis

2018

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Carotid cavernous fistula is an abnormal communication between the carotid arterial system and the cavernous sinus. We present an interesting, rare case of bilateral spontaneous ‘Barrow type- C’ fistula treated presumptively as conjunctivitis. A 66 year old patient presented in the eye casualty at North Devon District Hospital in January 2016, referred from her General practitioner complaining of bilateral red eyes. She was found to have large, prominently diffused and engorged scleral blood vessels on both sides along with raised intraocular pressures of 26mm of Hg bilaterally. The patient was diagnosed with an indirect carotic cavernous fistulas bilaterally in view of the clinical and radiology findings. Barrow type - C dural fistulas were reported to be seen bilaterally on radiology findings. Patient was referred for interventional treatment to the closest neurosurgical center where she had four failed attempts of coil embolization after which she was referred to a second neurosurgery center at Bristol where she underwent successful coil catheterization as the treatment for her carotid cavernous fistula. Indirect carotid cavernous fistula most commonly occur spontaneously. Bilateral spontaneous indirect carotid cavernous fistula is a very rare diagnosis and and there are very few cases reported in the literature without an underlying etiology or a known cause like Ehlers -Danlos syndrome or diabetes mellitus. Bilateral spontaneous carotid cavernous fistulas are difficult to diagnose due to mild symptoms and no history of trauma. We conclude that carotid cavernous fistulas are a threat to the vision if left untreated due to delayed diagnosis. We recommend considering bilateral carotid cavernous fistula as a differential diagnosis in patients with an ongoing history of red eyes or those unresponsive to conventional topical treatment for conjunctivitis like symptoms.

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