title: Intraorbital Arteriovenous Fistula Secondary to Penetrating Injury.
abstract: OBJECTIVE
  To describe the clinical and radiologic features and management of an intraorbital arteriovenous fistula secondary to penetrating injury.
  
  
  METHODS
  Interventional case report and literature review.
  
  
  RESULTS
  We describe a 13-year-old girl with a history of penetrating orbital injury who presented with proptosis, eyelid hyperemia, and orbital venous congestion. Computed tomography showed a large foreign body in the superiormedial orbit and an enlarged superior ophthalmic vein (SOV). Doppler ultrasonography revealed arterialized flow in the SOV. Removal of the foreign body did not alter the orbital symptoms. Carotid angiography disclosed a fistula between the ophthalmic artery and the SOV. The patient underwent an attempted coil embolization of the fistula through the femoral vein, which was unsuccessful, but she developed profound thrombosis of the SOV, which propagated through the orbital venous system. Although orbital venous congestive symptoms were acutely exacerbated, they regressed spontaneously within 1 month. The patient was followed for 23 months without recurrence.
  
  
  CONCLUSIONS
  Penetrating injury of the orbital apex may lead to the formation of an arteriovenous fistula, transvenous embolization of which may be complicated by thrombosis of the SOV. In our case, this unintentional result facilitated the resolution of the fistula.
authors.affiliation: Departments of *Ophthalmology and †Radiology, Uludag University, Bursa, Turkey; ‡Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada.
authors.forename: Bülent
authors.initials: B
authors.lastname: Yazc
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Yazc
authors.forename: Cüneyt
authors.initials: C
authors.lastname: Erdogan
authors.forename: Jack
authors.initials: J
authors.lastname: Rootman