A 49 year - old female was admitted to S.I.S Can Tho Hospital with complaints of left eye redness and swelling. The other symptoms were sometimes nausea, headache, feeling dizzy and having a ringing in her ears for more than a month and they seemed to not respond to medicines. History noticed that she suffered from a motor vehicle accident a few weeks ago, no fracture or hematoma of her skull, she was completely alert . After that trauma, she received antibiotics, anti-inflammatory drugs and pain relievers.
She denied a history of diabetes, hypertension, thyroid disease, stroke or any infectious diseases. There was also no history of fever , no surgery and no allergies to any medications.
Clinical examination:
- Result DSA: Carotid Cavernous fistula directly from the left internal carotid artery, causing reflux of blood into the ophthalmic vein, reducing cerebral perfusion.
- Treatment: Endovascular embolization with coils
- Post-treatment course was uncomplicated and left side proptosis and chemosis gradually subsided; no ringing in her ear, less headache and improvement in quality of life. She was discharged from hospital after a week.
She denied a history of diabetes, hypertension, thyroid disease, stroke or any infectious diseases. There was also no history of fever , no surgery and no allergies to any medications.
Clinical examination:
- Normal vital signs
- Normal pupil sizes and the pupillary light reflex
- 5/5 grade of muscle strength testing
- Left upper and lower lid erythema and edema
- Mild ptosis
- A systolic murmur was presented in the left eye
- Result DSA: Carotid Cavernous fistula directly from the left internal carotid artery, causing reflux of blood into the ophthalmic vein, reducing cerebral perfusion.
- Treatment: Endovascular embolization with coils
- Post-treatment course was uncomplicated and left side proptosis and chemosis gradually subsided; no ringing in her ear, less headache and improvement in quality of life. She was discharged from hospital after a week.