Abstract
A 3-year-old girl with trisomy 21 presented with progressive proptosis, scleral injection,
and pulsatility of her right eye 1 month following minimal blunt head trauma. Computed
tomography suggested a carotid cavernous fistula (CCF), which was confirmed by digital
subtraction angiography and further classified as an indirect, Barrow type D CCF.
Treatment was proposed because of vision-threatening elevated intraocular pressures.
Transvenous coil embolization of the CCF was successfully performed. The patient was
discharged to home 2 days after the procedure with immediate clinical improvement
of her proptosis and normalization of her intraocular pressures on follow-up ophthalmologic
visit 2 wk later.
Keywords
Carotid cavernous fistula - indirect carotid cavernous fistula - transvenous embolization
- pediatric - Down syndrome - trisomy 21
