{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:38:01Z","timestamp":1787071081393,"version":"build-2736575974"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract:<\/jats:title>\n                  <jats:p>Direct carotid cavernous fistula is an abnormal arterio-venous connection from the carotid artery to the cavernous sinus (CS), resulting in high-pressure arterial blood entering the low-pressure venous CS. Most often, it occurs posttrauma and presents with ipsilateral orbital signs. In this report, we describe the case of a 54-year-old man, who presented with a late-onset right-sided red eye and diplopia following contralateral (left sided) orbital trauma (road traffic accident 7 months ago). Ocular examination revealed signs of Lateral rectus palsy, axial proptosis, and elevated intraocular pressure with dilated episcleral vessels in the right eye. Clinical findings were consistent with the diagnosis of right-sided direct CCF. To our surprise, digital subtraction angiogram revealed a left CCF with prominence of signs on the contralateral side. He underwent near-total endovascular coiling of the fistula, with initial aggravation of symptoms followed by near-total resolution.<\/jats:p>","DOI":"10.4103\/ojo.ojo_258_23","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T13:15:10Z","timestamp":1730294110000},"page":"384-387","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Carotid-cavernous fistula due to contralateral orbital trauma"],"prefix":"10.4103","volume":"17","author":[{"given":"V. G.","family":"Namitha","sequence":"first","affiliation":[{"name":"Department of Paediatric Ophthalmology, Strabismus and Neurophthalmology, Giridhar Eye Institute, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Neena","sequence":"additional","affiliation":[{"name":"Department of Paediatric Ophthalmology, Strabismus and Neurophthalmology, Giridhar Eye Institute, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. R.","family":"Jayadevan","sequence":"additional","affiliation":[{"name":"Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,10,24]]},"reference":[{"key":"R1-20241030","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1097\/00001665-200303000-00020","article-title":"Traumatic carotid-cavernous fistula:Pathophysiology and treatment","volume":"14","author":"Fattahi","year":"2003","journal-title":"J Craniofac Surg"},{"key":"R2-20241030","doi-asserted-by":"crossref","first-page":"248","DOI":"10.3171\/jns.1985.62.2.0248","article-title":"Classification and treatment of spontaneous carotid-cavernous sinus fistulas","volume":"62","author":"Barrow","year":"1985","journal-title":"J Neurosurg"},{"key":"R3-20241030","first-page":"E13","article-title":"Diagnosis and management of dural carotid-cavernous sinus fistulas","volume":"23","author":"Miller","year":"2007","journal-title":"Neurosurg Focus"},{"key":"R4-20241030","first-page":"39","article-title":"Posttraumatic carotid-cavernous sinus fistula","volume":"5","author":"Stanton","year":"1999","journal-title":"J Craniomaxillofac Trauma"},{"key":"R5-20241030","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1038\/eye.2017.240","article-title":"Carotid-cavernous fistula:Current concepts in aetiology, investigation, and management","volume":"32","author":"Henderson","year":"2018","journal-title":"Eye (Lond)"},{"key":"R6-20241030","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1016\/S0161-6420(02)01166-1","article-title":"Cavernous sinus dural arteriovenous malformations:Patterns of venous drainage are related to clinical signs and symptoms","volume":"109","author":"Stiebel-Kalish","year":"2002","journal-title":"Ophthalmology"},{"key":"R7-20241030","doi-asserted-by":"crossref","first-page":"e803","DOI":"10.1097\/WNO.0000000000001181","article-title":"Contralateral ocular manifestations of a carotid cavernous fistula associated with primitive persistent trigeminal artery","volume":"41","author":"Hoang","year":"2021","journal-title":"J Neuroophthalmol"},{"key":"R8-20241030","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/S0002-9394(41)94125-9","article-title":"On the pathology of carotid-cavernous aneurysms (pulsating exophthalmos)","volume":"24","author":"Dandy","year":"1941","journal-title":"Am J Ophthalmol"},{"key":"R9-20241030","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1136\/bjo.50.10.599","article-title":"Arterio-venous shunt in the cavernous sinus with contralateral ocular signs","volume":"50","author":"Graham","year":"1966","journal-title":"Br J Ophthalmol"}],"container-title":["Oman Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ojo.ojo_258_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:41:12Z","timestamp":1787067672000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ojo.ojo_258_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/ojo.ojo_258_23","relation":{},"ISSN":["0974-620X","0974-7842"],"issn-type":[{"value":"0974-620X","type":"print"},{"value":"0974-7842","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9]]},"assertion":[{"value":"2023-10-25","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-09","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}