TY - JOUR A1 - Kumari, Namita A1 - Amitava, Abadan A1 - Akram, Sardar A1 - Grover, Shivani T1 - Direct, spontaneous carotid-cavernous fistula with a contracted kidney: A rare association Y1 - 2016/4/1 JF - Indian Journal of Ophthalmology JO - Indian J Ophthalmol SP - 323 EP - 325 VL - 64 IS - 4 UR - https://journals.lww.com/ijo/pages/default.aspx/article.asp?issn=0301-4738;year=2016;volume=64;issue=4;spage=323;epage=325;aulast=Kumari DO - 10.4103/0301-4738.182951 N2 - We report a case of a 20-year-old female having systemic hypertension who presented with right-sided proptosis, chemosis, and diminished vision, preceded by an acute episode of unilateral throbbing headache. Imaging studies revealed a right-sided direct, spontaneous carotid-cavernous fistula (CCF), aneurysm of internal carotid artery, bleed in the parieto-frontal lobe, and swelling of extraocular muscles. Abdominal ultrasound revealed a small contracted right kidney measuring 64 mm × 27 mm. A direct spontaneous CCF can occur spontaneously following rupture of intracranial aneurysm without any history of trauma or connective tissue disorder. Prompt diagnosis of intravascular malformations at initial presentation can prevent neurological complications and vision loss. A team approach including emergency physicians, neurosurgeons, and ophthalmologists is needed for the proper management of such patients. ER -