Abstract

A 60yr old female presented with redness, swelling and outward protrusion of right eye
which was insidious in onset, gradually progressive and painless, associated with headache. On examination , there was Right eye pulsatile axial proptosis , dilated tortuous vessels over lids , chemosis and episcleral congestion and limitation of extraocular movements in all gazes. The proptosis increase in size of valsalva manoeuvre. Contrast enhanced MRI brain and orbit showed dilated superior ophthalmic vein and cavernous sinus. Digital subtraction angiography showed rught direct carotid cavernous fistula with reflux into superior ophthalmic vein.
The patient was managed by endovasular occlusion via right per cutaneous trans femoral route with coils under general anaesthesia in interventional radiology department.