Increased intraocular pressure due to elevated episcleral venous pressure is a recognized complication associated with arteriovenous fistulas, which typically form between the carotid artery and the cavernous sinus. We report a case of a patient who developed paradoxical worsening syndrome a few days after he underwent a two-staged transarterial embolization procedure of a left sided ethmoidal arteriovenous fistula. The patient presented with signs of elevated episcleral venous pressure leading to intraocular hypertension caused by the iatrogenic partial obstruction of the left superior ophthalmic vein.
NussbaumBRGraupmanPTorokCM, et al.Delayed migration of onyx embolic agent after preoperative embolization of an arteriovenous malformation in a pediatric patient: a case report and review of the literature. Pediatr Neurosurg2023; 58: 45–52. doi: https://doi.org/10.1159/000529629. Epub 2023 Feb 13. PMID: 36780879.
2.
DasSGuptaAKRamalingiahAH, et al.Delayed migration of squid 18 following embolisation of a direct carotico-cavernous fistula. Interv Neuroradiol2018; 24: 210–213. doi: https://doi.org/10.1177/1591019917736909. Epub 2018 Jan 25. PMID: 29368536; PMCID: PMC5847003.
3.
AkmangitIDagliogluEKayaT, et al.Preliminary experience with squid: a new liquid embolizing agent for AVM, AV fistulas and tumors. Turk Neurosurg2014; 24: 565–570.
4.
SiaPISiaDITScroopR,et al.Orbital compartment syndrome following transvenous embolization of carotid-cavernous Fistula. Orbit2014; 33: 52–54. doi:https://doi.org/10.3109/01676830.2013.841717
5.
NagyZZNémethJSüvegesI,et al.A case of paradoxical worsening of dural-Sinus arteriovenous malformation syndrome after neurosurgery. Eur J Ophthalmol1995; 5: 265–270. doi:https://doi.org/10.1177/112067219500500412
6.
SergottRCGrossmanRISavinoPJ, et al.The syndrome of paradoxical worsening of dural-cavernous Sinus arteriovenous malformations. Ophthalmology1987; 94: 205–212. doi:https://doi.org/10.1016/S0161-6420(87)33472-4
