Carotid-cavernous fistula - Revision history

ClaireLewis at 00:18, 2 October 2019

2019-10-02T00:18:42Z

← Older revision		Revision as of 00:18, 2 October 2019
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	**Risk factors include [[connective tissue disease]] e.g. Ehler's Danlos		**Risk factors include [[connective tissue disease]] e.g. Ehler's Danlos

	=Clinical Features==		==Clinical Features==
	*Onset typically abrupt within hours to few days after initial insult, but may present weeks after trauma		*Onset typically abrupt within hours to few days after initial insult, but may present weeks after trauma
	*Symptoms due to arterialization of orbital veins		*Symptoms due to arterialization of orbital veins
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	==Evaluation==		==Evaluation==
	*Conventional angio is gold standard, but can be seen on CT/CTA or MRI/MRA of head/orbits		*Conventional angio is gold standard, but can be seen on [[head CT\|CT]]/CTA or [[brain MRI\|MRI]]/MRA of head/orbits

	==Management==		==Management==

ClaireLewis at 16:59, 17 August 2019

2019-08-17T16:59:32Z

← Older revision		Revision as of 16:59, 17 August 2019
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	==References==		==References==
	<references/>		<references/>
			[[Category:Vascular]]

ClaireLewis at 21:28, 27 January 2019

2019-01-27T21:28:16Z

← Older revision		Revision as of 21:28, 27 January 2019
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	==Background==		==Background==
	*Fistula between carotid and cavernous sinus		*Fistula between carotid and cavernous sinus
			*Majority arise from trauma
			**Exact mechanism unclear/variable, may arise from small tear in internal carotid or branches due to basilar [[skull fracture]] (esp. through sphenoid), shear forces, or abrupt increases in intraluminal pressure when compressed due to neck flexion<ref>UpToDate</ref>
			*May also occur spontaneously, due to aneurysms, thrombosis, or weakening in arterial wall
			**Risk factors include [[connective tissue disease]] e.g. Ehler's Danlos

	==Clinical Features==		=Clinical Features==
	*~~Bilateral conjunctival edema~~ and ~~pulsatile exophthalmos~~ (~~spontaneous in elderly~~, ~~secondary~~ to ~~trauma in young~~)		*Onset typically abrupt within hours to few days after initial insult, but may present weeks after trauma
			*Symptoms due to arterialization of orbital veins
			*Pulsating exophthalmos/[[proptosis]]
			*Raised [[intraocular pressure]]
			*[[Eye pain]] (ocular and/or orbital), [[headache]]
			*[[Red eye\|Chemosis]]
			*[[Diplopia]] or blurry vision
			*[[Abducens nerve palsy\|CN VI palsy]]
			**Esotropia (eye moves inwards), [[diplopia]]
			*[[Third nerve palsy\|CNIII palsy]]
			**Exotropia (eye moves laterally)
			**Ptosis
			**Pupillary dilation
			*Bruit (over eye or head)

			Possible complications include:
			*Acute angle [[glaucoma]], [[vitreous hemorrhage]], [[retinal detachment]]
			**Can lead to [[vision loss]]
			*[[ICH]], [[SAH]] (if fistula drains into cortical veins)
			*Severe [[epistaxis]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
			*Conventional angio is gold standard, but can be seen on CT/CTA or MRI/MRA of head/orbits

	==Management==		==Management==
			*5-10% close spontaneously<ref>Adams and Victor's Principles of Neurology, 10e</ref> remainder must be closed by interventional radiology (e.g. embolization) or surgically

	==Disposition==		==Disposition==
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	==See Also==		==See Also==
			*[[Red eye]], [[eye pain]]
			*[[Head trauma]]
			*[[Cranial nerve palsies]]

	==External Links==		==External Links==

Rossdonaldson1: /* Differential Diagnosis */

2018-11-20T22:04:22Z

Differential Diagnosis

← Older revision		Revision as of 22:04, 20 November 2018
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	==Differential Diagnosis==		==Differential Diagnosis==
			{{Bilateral Red Eyes}}

	==Evaluation==		==Evaluation==

Rossdonaldson1 at 20:59, 20 November 2018

2018-11-20T20:59:01Z

← Older revision		Revision as of 20:59, 20 November 2018
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	==Background==		==Background==
	~~Carotico-cavernous fistula~~		*Fistula between carotid and cavernous sinus
	*~~fistula~~ between carotid and cavernous sinus ~~presents with bilateral conjunctival edema and pulsatile exophthalmos (spontaneous in elderly, secondary to trauma in young)~~

	==Clinical Features==		==Clinical Features==
			*Bilateral conjunctival edema and pulsatile exophthalmos (spontaneous in elderly, secondary to trauma in young)

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: Created page with "==Background== Carotico-cavernous fistula *fistula between carotid and cavernous sinus presents with bilateral conjunctival edema and pulsatile exophthalmos (spontaneous in el..."

2018-11-20T20:57:14Z

Created page with "==Background== Carotico-cavernous fistula *fistula between carotid and cavernous sinus presents with bilateral conjunctival edema and pulsatile exophthalmos (spontaneous in el..."

New page

==Background==
Carotico-cavernous fistula
*fistula between carotid and cavernous sinus presents with bilateral conjunctival edema and pulsatile exophthalmos (spontaneous in elderly, secondary to trauma in young)

==Clinical Features==

==Differential Diagnosis==

==Evaluation==

==Management==

==Disposition==

==See Also==

==External Links==

==References==
<references/>