Supplementary Material for: A Rare Case of Direct Spontaneous Carotid-Cavernous Fistula In a 6-month-old Infant and Review of literature

Direct or Type A CCFs are the direct connection between the cavernous segment of the Internal carotid artery and the cavernous sinus. While most direct CCFs are caused by trauma, spontaneous direct CCFs are extremely rare in infants. We herein report a case of a 6-month-old child who came to our OPD with bulging in the right eye since 20 days after birth. On examination, there was right eye abduction limitation with no deviation, associated with proptosis. Bruit was present on auscultation. CEMRI showed an enlarged right cavernous sinus with dilatation of the superior ophthalmic vein suggestive of a carotid-cavernous fistula. The patient was referred to advance center where he was advised patch therapy to prevent amblyopia was kept under observation by neurosurgeon until the age of 3 years, after which he was scheduled to undergo trans arterial coiling.