Bilateral carotid-cavernous fistula with spontaneous resolution

RATIONALE Bilateral carotid-cavernous fistula (CCF) is rare and serious extra-ocular disease occurring in clinical which may result in severe complication. Unique manifestations and imaging examinations are important to the diagnosis. PATIENT CONCERNS A case of bilateral carotid-cavernous fistula in an 60-year-old healthy man caused by a head injury is reported. Further clinical symptoms and signs and imaging examinations lead to the correct diagnosis. DIAGNOSES Computed tomography angiography of the brain aroused suspicion of bilateral CCF. On physical examination, intraocular pressure in the right eye was 35 mm Hg, while the other eye was 56 mm Hg. INTERVENTIONS After diagnosis, the patient chose conservative treatment for some reasons. OUTCOMES The symptom of him had relieved in both eyes but no light perception in the right eye after two months telephone follow-up. LESSONS Our case study demonstrated that a highly suspicion must be maintained when managing such patients to prevent serious consequences. At the same time, the early diagnosis and treatment of the disease have a critical relationship to the prognosis of patients, which should be paid attention to.