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Dural carotid cavernous fistula following hypertensive emergency
  1. Geoffrey Law1 and
  2. Gavin Docherty2
  1. 1 Ophthalmology and Visual Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
  2. 2 Ophthalmology, Vancouver General Hospital, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Geoffrey Law, glaw89{at}


A 58-year-old woman was referred to the outpatient ophthalmology clinic with progressive bilateral eye redness and vision loss. She had presented 2 weeks earlier with an episode of hypertensive emergency. CT angiography revealed bilateral superior ophthalmic vein (SOV) dilation, prompting further workup with a cerebral angiogram. Subsequent imaging revealed an indirect (type D) carotid-cavernous fistula (CCF) with venous drainage into both SOVs and cavernous sinuses. Successful treatment of the CCF with coil embolisation required interdisciplinary teamwork between ophthalmologists and interventional neuroradiologists. The patient made a substantial visual recovery following treatment.

  • ophthalmology
  • anterior chamber
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  • Contributors All of the authors contributed significantly to this report. As the corresponding author of this manuscript, I confirm that GL contributed to study conception and design; both GL and GD drafted and revised the paper, gave final approval of the paper to be published and are both guarantors of the work. Both authors (GL and GD) had full access to all the data in the study and took full responsibility for the integrity of the data and the accuracy of the data analysis as well as the decision to submit for publication.

  • 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.

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