search for




 

Cavernous Sinus Dural Arteriovenous Fistula Presenting as Painful Isolated Abducens Nerve Palsy
Ann Optom Contact Lens 2019;18:27-31
Published online March 25, 2019
© 2019 The Korean Optometry & Contact Lens Study Society

Da-Yeong Kim, MD, Yooyeon Park, MD, Shin Hae Park, MD, PhD

Department of Ophthalmology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Correspondence to: Shin Hae Park, MD, PhD
Department of Ophthalmology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, #222 Banpo-daero, Seocho-gu, Seoul 06591, Korea, Tel: 82‐2‐2258‐6204, Fax: 82‐2‐599‐7405, E‐mail: vaccine@catholic.ac.kr
Received March 12, 2019; Revised March 19, 2019; Accepted March 19, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: To report a case of cavernous sinus dural arteriovenous fistula who presented with painful isolated abducens nerve palsy along with the characteristic conjunctival features.
Case summary: A 71-year-old female was referred to our clinic due to left eye pain and binocular diplopia. Esodeviation of 20 prism diopters was found with abduction limitation in the left eye. Slit lamp examination showed conjunctival injection, edema and corkscrew vessel dilatation in the left eye. Brain magnetic resonance angiography showed rapid filling and increased blood flow in the left superior ophthalmic vein and cavernous sinus. Cerebral angiography revealed direct venous drainage from the left cavernous sinus fistula into the left superior ophthalmic vein. After coil embolization, the left eye showed improvement in pain, conjunctival congestion and abduction limitation.
Conclusions: Cavernous sinus dural arteriovenous fistula should be considered when characteristic symptoms and conjunctival signs are accompanied with painful isolated abducens nerve palsy.
Keywords : Abducens nerve palsy; Ophthalmoplegia, painful


June 2019, 18 (2)