A rare case of traumatic arteriovenous fistula between middle meningeal artery and spheno parietal sinus who presented with only chronic red eye and literature review

ABSTRACT

Traumatic middle meningeal arteriovenous fistula with sphenoparietal sinus involvement is very rare. It is usually associated with skull fracture and intracranial hemorrhage. Ocular manifestation as sole presentation is extremely rare and only a few cases have been reported. We report a case of traumatic middle meningeal arteriovenous fistula with sphenoparietal sinus involvement 2 months after head trauma, presenting with left eye redness and dilated corkscrew episcleral vessel. CT scan showed venous out flow disturbance of the cavernous sinus with dilated ophthalmic veins. Transarterial endovascular embolisation of the fistula was done successfully; clinical and 6 months MRA resolution was noted. In conclusion, patient with traumatic middle meningeal arteriovenous fistula into the sphenoparietal sinus can present solely with subtle ocular symptoms. Transarterial endovascular embolisation is an effective procedure to close the fistula as seen in this case