Carotid Cavernous Fistulas (CCF). What an ophthalmologist should know: Review of cases undergoing endovascular treatment at the Dr. Asenjo Neurosurgery Institute, Santiago, Chile
DOI:
https://doi.org/10.56172/oftalmica.v22i.34Keywords:
CCF, carotid cavernous fistula, red eye, endovascular therapy, neuroradiology, interventional neuroradiology, embolization, NRxAbstract
Introduction: Carotid cavernous fistula are abnormal communications between arterial cerebral system and cavernous sinus. First line treatment nowadays is endovascular. The objetive of this study is to report a series of cases that received endovascular treatment at Instituto de Neurocirugía Dr. Asenjo at Chile hospital. Materials and Methods: Review of clinical records review of patients treated with an endovascular approach between 2017 and 2022. Clinical data reviewed included patient demographics and imaging findings. Results: We registered 28 patients, average age for the group was 54.8 years, 82.1% female. Most commonly reported symptoms were chemosis, proptosis, oculomotility alterations, headache or ocular pain. 11 cases were cases of a direct AV fistula. 16 cases were indirect and 1 case was mix case. Discussion: Carotid Cavernous fistulas must be suspected this pathology in a patient with or without cranial trauma, that progresses to proptosis, chemosis, with or without oculomotor or visual alterations. Clinical characterization of our patients was concordant with the reported in literature considering symptomatology, however, with predominance of an indirect and spontaneous fistulas. Conclusions: Ophthalmological evaluations is fundamental to determine differential diagnosis and management of concomitant pathology. Referral to interventional neuroradiology department is key for the patient to get the best treatment for it, endovascular treatment of the CC fistulas.
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