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Indirect Carotid Cavernous Fistula with Ocular Manifestations: A Case Report

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Abstract Carotid-cavernous fistulas are rare entity with incidence of less than 1%, refers to abnormal connections between the carotid artery and cavernous sinus. Indirect types usually occur in elderly female patients and can resolve spontaneously with conservative management like external manual compression of the carotid artery. We report a case of 65-year-old female who presented with complaints of redness, proptosis, chemosis, headache and ophthalmoplegia in her right eye. Digital subtraction angiography revealed Barrow type B indirect carotid-cavernous fistulas. External manual carotid compression was done after which her symptoms improved significantly. Thus, indirect type carotid-cavernous fistulas can occur spontaneously and could be a sight threatening condition especially in elderly females but can resolve with conservative management.

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Pooja Shrestha Department of Ophthalmology, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal Angira Shrestha Department of Ophthalmology, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal Tina Khoju Department of Ophthalmology, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal Richa Makaju Department of Ophthalmology, Dhulikhel Hospital, Dhulikhel, Kavre, Nepal Rajani Keshari Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal Rahul Gupta Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal Nigi Shrestha Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal

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