High-flow carotid cavernous fistula and 'white eye': A rare and easily misdiagnosed presentation - A case report and literature review

J R Coll Physicians Edinb. 2024 Apr 18:14782715241246572. doi: 10.1177/14782715241246572. Online ahead of print.ABSTRACTThe three classic symptoms of carotid cavernous fistula (CCF) are pulsating exophthalmos, bruit and conjunctival chemosis. Here, we present a clinical case of isolated abducens nerve palsy due to a high-flow CCF in an 84-year-old woman, without the typical congestive orbito-ocular features. It was a diagnostic challenge because, for patients older than 50 years with cardiovascular risk factors, ischaemic mononeuropathy is the most frequent aetiology. This case illustrates the least common type of CCF that can be easily misdiagnosed. Physicians should consider fistula as a possible diagnosis in a patient with isolated abducens nerve palsy even without the classic triad.PMID:38634267 | DOI:10.1177/14782715241246572

Source: Journal of the Royal College of Physicians of Edinburgh - April 18, 2024 Category: General Medicine Authors: Francisco Caiza-Zambrano Mart ín Gómez Lastra Silvia Garbugino Fabio Maximiliano Gonzalez Julio Galarza Menoscal Mauricio Benetti Yemina Neme Segura Luis Ariel Miquelini Claudia Uribe-Roca Manuel Fern ández-Pardal Luciana Le ón-Cejas Ricardo Reisin Pa Source Type: research