153 Carotid-Cavernous Fistula Causing Bradycardia Following Maxillofacial Trauma: A Case Report

نویسندگان

چکیده

Abstract A 53-year-old male presented to the local A&E department with a fractured mandible following single punch lower face, and was admitted under Oral & Maxillofacial Surgery. subsequent finding chemosis, relative afferent pupillary defect, minimal soft exophthalmos, reduced visual acuity colour vision in one eye, but no associated trauma orbits. CT scan showed sign of other injury, blood collection, small amount orbital emphysema didn’t appear be cause symptoms. heart rate 40bpm observed, ECG telemetry ruling out cardiac causes bradycardia. With this clinical picture space occupying lesion or collection identified on scan, an MRI head requested, which superior ophthalmic vein occlusion, resulting diagnosis direct carotid-cavernous fistula (CCF). The proptosis increased slowly over 24 hours became pulsatile. patient subsequently referred tertiary centre for treatment endovascular embolisation using coils, resulted full resolution signs This case presents rare acute presentation CCF after indirect trauma. It is assumed that bradycardia caused via oculo-cardiac reflex. could have led retrobulbar haemorrhage tension pneumo-orbit, triggering surgical needle decompression orbit. Such would had catastrophic consequences. reminder consider facial

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ژورنال

عنوان ژورنال: British Journal of Surgery

سال: 2021

ISSN: ['1365-2168', '0007-1323']

DOI: https://doi.org/10.1093/bjs/znab259.272