Right Eye Swelling And Pain


Consult Page

81M here with right eye swelling and pain, CT angiogram possible carotid-cavernous fistula

Initial Imaging

Figure 31.1, A coronal CTA of the head and neck (A) demonstrates early contrast opacification of bilateral cavernous sinuses. An axial reconstruction (B) again shows early contrast opacification of bilateral cavernous sinuses, and also a prominent draining superior ophthalmic vein (arrow), suggestive of a CCF.

Walking Thoughts

  • Is the onset of symptoms sudden or gradual? Is there antecedent trauma?

  • Does the patient take any anticoagulant or antiplatelet medications?

  • Has ophthalmology been consulted to evaluate the eye?

  • Is the fistula a direct or indirect fistula?

  • Does the fistula warrant urgent treatment?

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