Dr.Shakti Vanaar

Abstract

A 42 year old female presented with chief complain of left eye pain and progressive swelling of insidious onset for 3 months, BCVA 6/60, O/E – severe chemosis no fluctuation in size with changing position, proptosis with NO BRUIT, eye movements are restricted in all direction, sluggishly reacting pupil, normal IOP & fundoscopy findings.

Spiral CT scan findings suggestive of pseudotumour, patient is given 3 full dose of IV methyl prednisolone for 3 consequent days followed by full dose oral steroids for a week , no improvement for a week.MRI brain with contrast showed signs suggestive of carotid cavernous fistula with pseudotumor which was inconclusive followed by IV vessel angiography of brain showed finding suggestive of Left Cavernous Dural AV malformation.

Patient was then prepared for AV malformation embolization.

carotid-cavernous fistula can simulated as pseudotumour. And cavernous sinus dural AV malformation can have their initial manifestation as proptosis.