Professional paper

Carotid Cavernous Fistulas in Postmenopausal Women

Jasna Pavičić-Astaloš
Tamara Knežević
Renata Iveković
Eugenia Tedeschi-Reiner
Tomislav Gregurić
Goran Bojanić
Josip Hat
Zdravko Mandić

Abstract

During the last five-year period, eight patients were hospitalized at University Department of Ophthalmology, Sestre milosrdnice University Hospital, for elaboration and therapy of spontaneous indirect carotid cavernous fistulas. The aim of this report is to present our experiences in the diagnosis, treatment and follow up of patients with carotid cavernous fistulas. All patients were postmenopausal women, mean age 69.75±7.3 years, without any trauma in their history. The most common symptoms were proptosis, low vision and chemosis. Ultrasound, computerized tomography, magnetic resonance imaging and angiography were used as diagnostic methods. Endovascular balloon occlusion was the treatment of choice in all patients except for one with spontaneous closure of the fistula, whereas another one refused this mode of treatment. The first follow up examination at one month after therapy showed improvement of ocular status. There was no pain, bruit, chemosis, pulsations of the globe, headache or double vision, while periorbital edema, proptosis, dilatation of retinal veins and intraocular pressure were reduced. During the six-month follow up period, no recurrence was recorded. Spontaneous fistulas described in this study tend to be dural shunts. These shunts have a predilection to develop in postmenopausal women, possibly due to atherosclerosis, hypertension and alterations in blood coagulation associated with hormonal changes.

Keywords

Carotid cavernous fistula; Dural shunt; Postmenopausal women

Hrčak ID:

22767

URI

https://hrcak.srce.hr/22767

Publication date:

1.4.2008.

Article data in other languages: croatian

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