Protruding eyes and tinnitus due to cerebrovascular leakage

She received medical treatment for 4 months but did not recover, had insomnia, and her health deteriorated. She went to Tam Anh General Hospital in Ho Chi Minh City for examination. MRI image of 3 Tesla of the brain, examination of cerebral vessels without contrast injection showed that Ms. Yen had a cerebral arteriovenous fistula (abnormal cerebral arteriovenous connection) in the dura mater of the cavernous sinus, causing large dilatation of the left eye vein. .

On October 30, Dr. Duong Dinh Hoan, Head of the Neurointerventional Unit, Center for Diagnostic Imaging and Interventional Radiology, Tam Anh General Hospital, Ho Chi Minh City, said that cerebrovascular leakage is the cause. causing patients to have bulging eyes and tinnitus. If not treated, the patient has a high risk of stroke, hemorrhagic stroke, which is life-threatening.

Doctor Thi Van Ginger, Deputy Director of the Vascular Intervention Center, Head of the Endovascular Intervention Unit, Tam Anh General Hospital, Ho Chi Minh City, said the fistula originates from the cavernous carotid artery, draining blood. into the ophthalmic vein, draining into the left facial vein, then draining into the left brachiocephalic vein. The small, winding blood vessels made it difficult for doctors to access Ms. Yen’s fistula.

The patient was treated with endovascular fistula occlusion. This is a minimally invasive method, highly effective and safe, especially for elderly patients, according to Dr. Ginger. The team inserted a small catheter into a vein in the groin area and used a microcatheter to enter the winding blood vessels, reaching the fistula site. Then, specialized materials are inserted to clog the fistula.

DSA digital subtraction angiography results after intervention showed that the cavernous sinus dural arteriovenous fistula was completely occluded. One day later, Ms. Yen’s tinnitus was gone, the redness and protrusion of her left eye improved, her health recovered well, and she was discharged from the hospital the next day.

Cavernous sinus dural arteriovenous fistula often occurs in elderly women. Common symptoms of the disease include redness, bulging eyes, tinnitus or vision abnormalities due to damage to nerves 3, 4, 5, 6.

Dr. Ginger said that cavernous sinus dural arteriovenous fistula is often difficult to diagnose because symptoms easily overlap with eye diseases, leading to untimely treatment. Patients with redness, bulging eyes, ringing in the ears or unusual vision changes should promptly seek examination and treatment at an ophthalmology and neurology specialist. The doctor may prescribe a 3-Tesla MRI of the brain, combined with an examination of the cerebral vessels without the need for contrast injection to check and promptly detect cerebrovascular abnormalities, treat them early, and avoid waiting for a long time, leading to complications. dangerous complications.