Parth Modi¹*, Abhishek Katyal² and Daljit Singh²

¹Department of Neurosurgery, Baroda Medical College and Sir Sayajirao Gaikwad Hospital, Vadodara, Gujarat, India
²G. B. Pant Institute of Post-graduate Medical Education and Research (GIPMER), New Delhi, India

*Corresponding Author: Parth Modi, Department of Neurosurgery, Baroda Medical College and Sir Sayajirao Gaikwad Hospital, Vadodara, Gujarat, India.

Received: April 09, 2024; Published: May 22, 2024

Abstract

class="07-OS-Email-address-content" style="margin: 0in; text-align: justify; line-height: 150%;">Direct CCF most commonly occurs as a result of trauma, forming a direct fistula between the internal carotid artery and the cavernous sinus. As the high pressure of the internal carotid artery is transmitted to the cavernous sinus, it commonly leads to oculomotor, trochlear and abducens cranial nerve palsy. The case report described herein describes young adult presented with recent onset right eye proptosis and binocular horizontal diplopia due to bilateral lateral gaze palsy. The patient had history of RTA 1 year back. The patient was initially treated for facial bone complex fractures, following which due to persistent symptoms she was then evaluated for infectious and neoplastic etiology. The patient was diagnosed with right CCF on CTA. Endovascular embolization was done resulting in resolution of proptosis and improved prognosis. However, It is very rare for post-traumatic, unilateral CCF to present with contralateral symptoms and bilateral abducent palsy without affecting other cranial nerved in direct CCF. Therefore, patients presenting with B/L abducent palsy should evaluated for CCF with either a CTA/DSA as early diagnosis and treatment results in improved patient outcome.

Keywords: RTA: Road Traffic Accident; CCF: Carotid- Cavernous Fistula; CTA: Commuted Tomography Angiography; DSA: Digital Substraction Angiography; ORIF: Open Reduction and Internal Fixation

References

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Citation

Citation: Parth Modi., et al. “Unilateral Direct High-Flow Traumatic Carotid-Cavernous Fistula Presenting as Isolated Bilateral Abducent Nerves Palsy: A False Localizing Sign”. Acta Scientific Neurology 7.6 (2024): 16-20.

Copyright

Copyright: © 2024 Parth Modi., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.