Almost blind due to sequelae after a traffic accident

HCMCA 21-year-old man with a blood leak in his eye after a traffic accident, almost went blind due to a misdiagnosis of corneal inflammation.

The patient’s left eye has red streaks in the middle of the iris, like a crescent moon, which is swollen and painful. Since October, he has examined many places, diagnosed and treated keratitis, not cured. Red and swollen left eye, slightly protruding, fading vision.

At Thu Duc District Hospital, the doctor suspects that the patient is not suffering from keratitis. MRI imaging results showed that the patient had a leakage of left cavernous sinus artery. Exploiting medical history, in April, a young man had a traffic accident, had to be hospitalized for more than two months, treated for head injury, facial jaw injury, femoral fracture and lung crush.

“This is a dangerous sequelae after trauma. Patients are susceptible to blindness, stroke due to cerebral hemorrhage, even death if not detected, intervening promptly”, said Dr. Khanh.

He explained, cavernous carotid artery fistula disease is common in patients with a history of head and back trauma after traffic accidents. The injury previously torn apart, creating a fistula in the carotid artery, causing blood to flow through the cavity, causing the patient to have the above symptoms. Complex and rare disease, easy to confuse with eye diseases. Young men have been mistakenly diagnosed and treated for keratitis.

Initially, doctors intended to plug the carotid artery fistula with a balloon insert. However, the leak is quite small, not workable. Then, the leak sealing material is changed to a coil (metal coil). Basically, ball placement or coil placement is the same in terms of method and efficiency, only with a different material.

The surgery took place successfully, on December 25. The patient received intravascular intervention. Doctors thread the tube through the femoral artery, into the blood vessels of the brain, close the fistula site and seal the hole with coil. This procedure helps to avoid damage to other organs, and shortens the treatment time, patients can be discharged after 3 to 5 days.

Currently, the patient’s eye has reduced swelling, redness, pains and conditions for discharge, Dr. Khanh informed.

The patient’s eyes are red and swollen before surgery (photo above) and return to normal after surgery (bottom photo). Image: Hospital provided.

Letter Anh


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