Abstract:
Due to the anatomical proximity between the skull and the face, maxillofacial trauma can often cause injuries to cranial structures. Among these complications are carotid-cavernous fistulas (CCF), which are rare in maxillofacial trauma, although their etiology is usually traumatic. They are described as an atypical communication between the internal carotid artery and the cavernous sinus, which can generate a sudden change in the direction and distribution of blood flow between the brain and orbit. This paper aims to report a case of craniomaxillofacial trauma in which the patient evolved with diplopia, palpebral ptosis, and ophthalmoplegia of the left eye, diagnosed as traumatic CCF. The oral and maxillofacial surgery and traumatology team of the University Hospital of Western Paraná was observed these symptoms for the first time during post-operative follow-up after one day of surgery to repair mandibular fractures of the patient in question. With the identifying the signs and symptoms, a neurosurgery was requested for assessment and management. After clinical evaluation and imaging tests, they diagnosed the condition as CCF 5 days after the mandibular fractures and the patient was referred for treatment. Surgery was performed, in the same day, to resolve the CCF with the endovascularly by embolization with micromoles. The CCF was resolved and the patient continued on outpatient follow-up, progressing without sequelae from the CCF or mandibular fractures.
摘要:
由于头骨和面部之间的解剖接近,颌面部创伤通常会导致颅骨结构受伤。这些并发症包括颈动脉海绵窦瘘(CCF),这在颌面部创伤中是罕见的,尽管他们的病因通常是创伤性的。它们被描述为颈内动脉和海绵窦之间的非典型连通,这可能会导致大脑和眼眶之间血流方向和分布的突然变化。本文旨在报告一例患者发展为复视的颅颌面外伤,眼睑下垂,左眼的眼肌麻痹,诊断为创伤性CCF.XXX的口腔颌面外科和创伤学团队在手术后一天的术后随访中首次观察到了这些症状,以修复有问题的患者的下颌骨骨折。随着体征和症状的识别,我们要求神经外科进行评估和管理.经过临床评估和影像学检查,他们在下颌骨骨折后5天诊断为CCF,患者被转诊接受治疗.进行了手术,在同一天,通过微摩尔栓塞在血管内解决CCF。CCF得到解决,患者继续进行门诊随访,进展无CCF或下颌骨骨折后遗症。