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Post-traumatic carotid-cavernous fistula with bilateral proptosis simulating cavernous sinus thrombosis
  1. Nirupama Kasturi1,
  2. Pooja Kumari1,
  3. Gayatri Nagarajan1 and
  4. Nagarajan Krishnan2
  1. 1 Ophthalmology, JIPMER, Puducherry, India
  2. 2 Radiodiagnosis, JIPMER, Puducherry, India
  1. Correspondence to Dr Nirupama Kasturi, kasturiniru{at}


A 48-year-old woman presented with bilateral non-pulsatile proptosis and ophthalmoplegia after 3 days following blunt orbital trauma. It was associated with fever, malaise and loss of vision in right eye. She was provisionally diagnosed with cavernous sinus thrombosis and was treated with intravenous antibiotics with no improvement. A subtle bruit was present on examination, and digital subtraction angiography revealed a right direct (type A) carotid-cavernous fistula (CCF). The patient underwent right coil embolisation of direct CCF. On follow-up at 4 months, her proptosis resolved completely and extraocular movements improved.

  • eye
  • trauma
  • interventional radiology

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  • Contributors NKa: Manuscript writing, editing, patient care. PK: Manuscript review, photographs, patient care. GN: Manuscript review and patient care. NKr: Radiology images and Patient care.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.