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CASE REPORT
Year : 2021  |  Volume : 7  |  Issue : 4  |  Page : 289-293

Spontaneous resolution of nontraumatic bilateral Barrow Type D indirect carotid-cavernous fistulas: A case report


1 Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
2 Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA
3 Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health; Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo; Canon Stroke and Vascular Research Center, University at Buffalo; Department of Neurosurgery, Jacobs Institute, Buffalo, New York, USA

Correspondence Address:
Adnan H Siddiqui
University at Buffalo Neurosurgery, 100 High Street, Suite B4, Buffalo, NY 14203
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bc.bc_50_21

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A Caucasian man in his 60s with a history of Cognard Type IIB dural arteriovenous fistula presented to the emergency room with right eye proptosis, chemosis, hyperemia, epiphora, diplopia, and blurred vision. Magnetic resonance imaging and magnetic resonance angiography revealed spontaneous, bilateral Barrow Type D carotid-cavernous fistulas (CCFs) that were later confirmed through cerebral angiography. The patient had no history of head or ocular trauma. Given the acute nature of presentation and worsening diplopia, the patient was scheduled for transvenous embolization. However, during the preprocedure angiogram, spontaneous resolution of the bilateral CCFs was observed. Complete resolution of all symptoms was noticed during follow-up. Given the rare nature of bilateral, indirect CCFs, our case stands out as the only reported instance whereby resolution of bilateral, indirect CCFs occurred spontaneously without any intervention.


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