Abstract:
The three classic symptoms of carotid cavernous fistula (CCF) are pulsating exophthalmos, bruit and conjunctival chemosis. Here, we present a clinical case of isolated abducens nerve palsy due to a high-flow CCF in an 84-year-old woman, without the typical congestive orbito-ocular features. It was a diagnostic challenge because, for patients older than 50 years with cardiovascular risk factors, ischaemic mononeuropathy is the most frequent aetiology. This case illustrates the least common type of CCF that can be easily misdiagnosed. Physicians should consider fistula as a possible diagnosis in a patient with isolated abducens nerve palsy even without the classic triad.
摘要:
颈动脉海绵窦瘘(CCF)的三个典型症状是搏动性眼球突出,瘀伤和结膜化学。这里,我们介绍了一个84岁女性由于高流量CCF引起的孤立的外展神经麻痹的临床病例,没有典型的充血性眼性特征。这是一个诊断挑战,因为,对于50岁以上有心血管危险因素的患者,缺血性单神经病是最常见的病因。这种情况说明了最不常见的CCF类型,很容易被误诊。即使没有经典的三联征,医生也应将瘘管视为孤立的外展神经麻痹患者的可能诊断。