Aggravation of Fistula between a Posterior Communicating Artery Aneurysm and the Cavernous Sinus Symptoms after Neurosurgical Clipping and Embolization: A Case Report
Publish Year: 1397
نوع سند: مقاله کنفرانسی
زبان: English
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شناسه ملی سند علمی:
ACSOMED28_061
تاریخ نمایه سازی: 1 دی 1397
Abstract:
Purpose: Fistula between a posterior communicating artery aneurysm and the cavernous sinus is very rare and few cases have been reported in the literature so far. Methods: We report two patients including a 51-year-old man and a 43-year-old woman, who were known cases of treated fistula between a posterior communicating artery aneurysm and the cavernous sinus via neurosurgical clipping and embolization, who presented with decreased vision, eye proptosis, conjunctival chemosis and dilated episcleral vessels. Results: Further evaluation demonstrated that the patients had elevated intraocular pressure with a shallow anterior chamber.Fundus examination and imaging studies including optical coherence tomography and fluorescein angiography revealed choroidal effusion with retinal nerve fiber layer changes. Based on their history and imaging studies a diagnosis of secondary choroidal effusion with angle closure glaucoma and venous stasis retinopathy was made, and patients were treated with anti-glaucoma medications including eye drops of timolol, brimonidine, oral medication with acetazolamide and peripheral iridotomy in the affected eye. Conclusion: In all patients with an internal carotid artery (or its branches) and cavernous sinus fistula, even in treated patients close ophthalmic follow-up visits must be done to reduce the risk of vision threatening side conditions like choroidal effusion and secondary angle closure glaucoma.
Authors
Kaveh Abri Aghdam
Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Naveed Nilforushan
Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Amin Zand.
Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran