Question

Describe the important clinical features of Carotico-Cavernous Fistula (CCF).

Hint:

Proptosis, chemosis, and a pulsatile bruit are key clinical signs of CCF. Early intervention is critical to prevent irreversible damage.

Answer 1

Step 1: Clinical Features of Carotico-Cavernous Fistula (CCF).
The clinical features of CCF depend on the type (direct or indirect) and the severity of the fistula. Common clinical manifestations include:
1. Proptosis: One of the most common symptoms, where the eye bulges outward due to increased blood flow in the ophthalmic veins. This is especially pronounced in direct fistulas.
2. Chemosis: Swelling of the conjunctiva due to increased venous pressure in the ocular veins. It is a characteristic feature of CCF.
3. Pulsatile Exophthalmos: A hallmark of direct CCF, where the eyeball moves in sync with the pulse of the carotid artery, often accompanied by a palpable thrill.
4. Vision Impairment: Due to increased pressure in the venous system, there can be optic nerve compression, leading to visual disturbances or even blindness in severe cases.
5. Ocular Bruit: The sound of blood flow through the abnormal fistula may be heard through a stethoscope placed over the eye. This is often seen in direct CCF.

Step 2: Conclusion.
CCF is a serious condition with significant ocular and neurological implications. Early diagnosis and management are crucial to prevent complications such as blindness or stroke.