• Lan Ke, Yan-Ning Yang, and Jing Yuan.
• Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
• Medicine (Baltimore). 2017 May 1; 96 (19): e6869.

RationaleBilateral carotid-cavernous fistula (CCF) is rare and serious extra-ocular disease occurring in clinical which may result in severe complication. Unique manifestations and imaging examinations are important to the diagnosis.Patient ConcernsA case of bilateral carotid-cavernous fistula in an 60-year-old healthy man caused by a head injury is reported. Further clinical symptoms and signs and imaging examinations lead to the correct diagnosis.DiagnosesComputed tomography angiography of the brain aroused suspicion of bilateral CCF. On physical examination, intraocular pressure in the right eye was 35 mm Hg, while the other eye was 56 mm Hg.InterventionsAfter diagnosis, the patient chose conservative treatment for some reasons.OutcomesThe symptom of him had relieved in both eyes but no light perception in the right eye after two months telephone follow-up.LessonsOur case study demonstrated that a highly suspicion must be maintained when managing such patients to prevent serious consequences. At the same time, the early diagnosis and treatment of the disease have a critical relationship to the prognosis of patients, which should be paid attention to.

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