Isolated contralateral abducens palsy in direct carotid-cavernous fistula.
Abducens Nerve Diseases
/ etiology
Angiography, Digital Subtraction
Carotid Artery, Internal
/ diagnostic imaging
Carotid-Cavernous Sinus Fistula
/ diagnosis
Cavernous Sinus
/ diagnostic imaging
Child
Endovascular Procedures
Exophthalmos
/ etiology
Head Injuries, Closed
/ complications
Humans
Male
Tomography, X-Ray Computed
Treatment Outcome
cranial nerves
neuro-opthalmology
neuroimaging
ophthalmology
trauma CNS /PNS
Journal
BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291
Informations de publication
Date de publication:
21 Dec 2020
21 Dec 2020
Historique:
entrez:
29
12
2020
pubmed:
30
12
2020
medline:
23
2
2021
Statut:
epublish
Résumé
Post-traumatic direct carotid-cavernous fistulas may develop in patients with a closed head injury. The classical presentation is the Dandy's triad-chemosis, pulsatile proptosis and orbital bruit. Associated findings may include orbital pain, dilated episcleral corkscrew vessels, vision deficit and cranial nerve palsies. Cranial nerves-oculomotor (III), trochlear (IV), ophthalmic (V1), and maxillary (V2) divisions of trigeminal and the abducens (VI) lie in close association of the cavernous sinus. Abducens nerve (VI) lies close to the intracavernous internal carotid artery, within the substance of the sinus and is hence easily susceptible to vascular insult. The two sinuses connect across the midline and communicate freely with each other. Back pressure changes can present with the same sided or bilateral cranial nerve palsies. We report a rare association of a long-standing left-sided carotid-cavernous fistula with right eye abduction deficit and contralateral abducens palsy.
Identifiants
pubmed: 33370953
pii: 13/12/e238746
doi: 10.1136/bcr-2020-238746
pmc: PMC7754622
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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