%0 Journal Article
%T Spontaneous Carotid-cavernous Fistula and Subarachnoid Hemorrhage - Spontaneous Carotid-cavernous Fistula and Subarachnoid Hemorrhage - Open Access Pub
%A Apetse kossivi kumako vinyo
%A Balogou agnon ay¨¦lola koffi
%A Belo mofou
%A Guinhouya Kokou Mensah
%A Kombate Damelan
%J OAP | Home | Journal of Neurological Research And Therapy | Open Access Pub
%D 2018
%X Carotid-cavernous fistula (CCF) is a rare neurological condition with risk of death in case of inappropriate management. The outcome of this pathology is very bad in developing countries with inadequate technical Platform. We underlined the main difficulties of the management of CCF in a 43 years-old Togolese woman with a fatal outcome. DOI 10.14302/issn.2470-5020.jnrt-16-1279 The carotid-cavernous fistula (CCF) is a communication between the internal carotid artery and the cavernous sinus vein. This is a rare condition 1. It is often described in trauma but the CCF can be spontaneous. CCF can be direct in traumatic condition (direct communication between intra-cavernous carotid artery and the cavernous sinus vein) or indirect 2. The indirect CCF is spontaneous and can be related to cranial venous sinus thrombosis, carotid aneurysm or previous cranial surgeries. The great CCF engages the functional and vital prognosis if the management is not early and appropriate. In developing countries, the mortality rate is high because of lack of arteriography. We report a case of CCF. A 43-year lady, right-handed, single and mother of two children, was admitted in emergency neurology for intense headaches with vomiting, 2 generalized seizures and a sudden onset of consciousness disorders on April 19, 2016. Symptoms began two hours before her admission. She had no vascular history. The physical examination revealed intense headaches. The blood pressure was 130/80 mmHg with normal temperature (36.8 ¡ã C). There was a light comas status with a Glasgow score of 12/15, a stiff neck, left hemiparesis and a bilateral Babinski reflex, right ptosis associated with reactive mydriasis, an exophthalmos and a total right ophthalmoplegia. Ophthalmologic examination revealed a right visual acuity of 1/10 with macular chorioretinitis. The brain CT scan (Figure 1) displayed a dilatation and hyper-density of right cavernous sinus with dilatation of the right ophthalmic vein associated with a subarachnoid hemorrhage. The routine biological tests were normal. An analgesic treatment had been administered in addition to nimodipine and mannitol (against brain edema) and clonasepam (against seizures). Unfortunately, as interventional neuroradiology and arteriography are not available, the patient had died on the seventh day of hospitalization in a context of increased intracranial hypertension. Figure 1. Brain CT scan displaying right CCF (Arrow B) with subarachnoid hemorrhage (Arrow C) and right ophtalmic vein dilatation (Arrow A) The CCF is a rare condition with bad functional outcome
%U https://www.openaccesspub.org/jnrt/article/356