case_images: PMC10601783_01
case_images: a Primary gaze with inferior dystopia. b Down gaze showing right eye proptosis and eyelid fullness. c Right abduction limitation. d Levoversion.
case_images: cop-2023-0014-0001-531568_F01.jpg
case_images: PMC10601783_01_cop-2023-0014-0001-531568_F01.jpg
case_images: F1
case_images: On examination, it was a non-reducible, non-compressible, and pulsatile proptosis with inferior dystopia (Fig. 1a, b). The extraocular movement was limited to the right eye abduction with few dilated conjunctival vessels in the temporal region (Fig. 1c).
case_images: a CEMRI T1W sagittal section showing hyper-intense dilated cavernous ICA/cavernous sinus (red arrow) with retrograde flow toward the SOV (yellow arrow). b T2W axial section showing the right dilated SOV (red arrow). c CEMRI T1W axial showing enlarged right cavernous sinus/cavernous ICA with lateral bulging (red arrow) and normal left ICA cavernous segment (yellow arrow). d T2W sagittal section showing an enlarged cavernous sinus/cavernous ICA (red arrow).
case_images: cop-2023-0014-0001-531568_F02.jpg
case_images: PMC10601783_01_cop-2023-0014-0001-531568_F02.jpg
case_images: F2
case_images: CEMRI showed an enlarged right cavernous sinus (Fig. 2a) with multiple tortuous and dilated vascular structures within, with asymmetrical dilatation of the right SOV (Fig. 2b), suggesting right carotid-cavernous fistula (Type A). The largest intracavernous vasculature diameter is 12.5 mm, causing lateral bulging of the right cavernous sinus lateral wall (Fig. 2c).