| 본문 : Purpose: To report a patient with delayed onset abducens nerve palsy and horner syndrome after endovascular treatment for traumatic carotid-cavernous fistula (CCF).
Case Summary: A 68-year-female visited to the ophthalmic department for gradual onset of left ptosis and horizontal diplopia. She had undergone endovascular treatment for left traumatic CCF after car accident 10 years ago. The patient was told that the outcome of procedure was favorable. The left ptosis developed gradually 6 years after the procedure and diplopia also occurred. The left eye showed miosis and the anisocoria increased in dim light. The extraocular examination showed 30 prism diopters (PD) left esotropia at primary gaze and -4 abduction limitation of the left eye. The recurrence of CCF was suspected, however, the magnetic resonance imaging with magnetic resonance angiography of brain did not reveal any recurred finding of CCF. There was no improvement of esotropia during 6 months of follow-up, therefore the strabismus surgery was performed.
Conclusions: The delayed onset abducens nerve palsy and horner syndrome can occur even after the successful endovascular treatment of CCF. The strabismus surgery can be considered in patients without spontaneous improvement of diplopia. |