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Journal of Pediatric Neuroradiology 2013; 02(02): 175-180
DOI: 10.3233/PNR-13062
Case Report
Georg Thieme Verlag KG Stuttgart – New York

Transvenous coil embolization of an indirect, Barrow type D carotid-cavernous fistula in a 3-year-old with Down syndrome

Collin M. Torok
a   Department of Radiology, The Johns Hopkins Hospital, Baltimore, MD, USA
,
Monica S. Pearl
a   Department of Radiology, The Johns Hopkins Hospital, Baltimore, MD, USA
b   Division of Interventional Neuroradiology, The Johns Hopkins Hospital, Baltimore, MD, USA
c   Interventional Neuroradiology Section, Children’s National Medical Center, Washington, DC, USA
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Publication History

07 August 2012

25 September 2012

Publication Date:
29 July 2015 (online)

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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