Turkish Neurosurgery
Pediatric Bilateral Traumatic Caroticocavernous Fistula: Corkscrew Eyelid Vessels as an Indicator of Severe Congestion
Umut Karaca1, Murat Kucukevcilioglu2, Onder Ayyildiz2, Fatih Mehmet Mutlu2, Gokhan Ozge2
1Süleyman Demirel Üniversitesi, Ophthalmology, Isparta,
2Gulhane Education and Research Hospital, Ophthalmology, Ankara,
DOI: 10.5137/1019-5149.JTN.30838-20.2

An 11-year-old girl presented with bilateral traumatic caroticocavernous fistula (CCF) associated with corkscrew eyelid vessels, which were considered indicators of severe congestive disease in this case. Direct CCFs are commonly associated with a history of head trauma, high-flow, prominent eye findings, and requirement for an early treatment. Indirect CCFs on the other hand are usually spontaneous, and associated with low flow, subtle findings and a benign course. Both direct and indirect CCFs are rare in the pediatric population. Coil embolization was performed; similar to other congestive findings such as proptosis, orbital bruit, increased intraocular pressure, congested scleral and retinal vessels, engorged eyelid vessels resolved immediately after coil embolization. This pediatric case is unique given the CCF was bilateral and was associated with prominent dilatation of the eyelid vessels, named for the first time as corkscrew eyelid vessels.

Corresponding author : Umut Karaca