Resumo

NUNEZ-ALCANTARA, Nátali V et al. Carotid-cavernous fistula with bilateral neuro-ophthalmologic symptoms and venous ischemia: A case report. Rev Neuropsiquiatr [online]. 2017, vol.80, n.2, pp.137-143. ISSN 0034-8597.  http://dx.doi.org/https://doi.org/10.20453/rnp.v80i2.3093.

The carotid-cavernous fistula is an abnormal communication between the carotid artery and the cavernous sinus that induces a pathological arterio-venous shunt, and whose origin may be traumatic or spontaneous. Its clinical symptoms are related to changes in the direction of the venous drainage and blood flow through the fistula, and include ocular symptoms as chemosis, exophthalmos and orbital murmur besides neurological manifestations such as venous infarctions and intracerebral hemorrhage. Its presence is confirmed by digital subtraction angiography and the generally accepted classification is based on Barrow’se proposal. Endovascular treatment has been the preferred treatment approach for the past two decades; however, surgical treatment remains an option when the former fails or is not possible. The case of a 71 year-old woman with a history of traumatic brain injury is reported: the patient was diagnosed with carotid-cavernous fistula and bilateral neuro-ophthalmic symptoms associated with left temporal venous infarction, and underwent surgical treatment with a favorable clinical outcome.

Palavras-chave : Carotid cavernous sinus fistula; carotid artery injuries; cerebral infarction; exophthalmos.

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