Vol 58, No 6 (2007)
Case report
Published online: 2007-11-21
Diagnostic difficulties in differentiating of arteriovenous fistula - case report
Endokrynol Pol 2007;58(6):530-533.
Abstract
Arteriovenous carotid-cavernous fistula is an abnormal connection between the dural branches of carotid artery or vertebral
artery and the dural sinuses. Its clinical manifestations can resemble the crucial signs of thyroid orbitopathy, an inflammatory
disorder of the orbit associated with Graves’ disease. Therefore, differential diagnosis of thyroid orbitopathy and
the congestion of the orbit seen in arteriovenous fistula is often clinically and radiologically confused. This is the case report
of the simultaneous occurrence of dural arteriovenous fistula in 59 years old woman. The first manifestation was unilateral
exophthalmia. After Computer Tomography and Magnetic Resonance Imaging were performed, the preliminary diagnosis
of thyroid orbitopathy was established. The response of eye disorder to corticosteroid treatment resulted in evident
deterioration. This prompted a reconsideration of the diagnosis and a new evaluation of the patient with sensitive techniques,
leading to the final diagnosis of arteriovenous fistula.
Keywords: arteriovenous fistulathyroid orbitopathyexophthalmiadifferential diagnosis
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