- Ocular Syphilis Misdiagnosed as Giant Cell Arteritis
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Jeongsu Hwang, Jong-hee Sohn, Sang-Hwa Lee, Byoungchul Choi, Eungue Lee, Wonseok Jeon
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Published online June 30, 2021
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- 거대세포 동맥염으로 오인한 안매독 1례
- A Case of Optic Glioma Presenting as Headache and Visual Loss
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Byoungchul Choi, Jeongsu Hwang, Young-Il Kim, Sang-Hwa Lee, Yerim Kim, MSc
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Published online June 30, 2020
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- 두통과 급격한 시야장애를 동반한 시신경 교종
- Spontaneous Pneumocephalus with Skull Defects in Patient with Acute Bacterial Meningitis
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Seonghyeon Kim, Subum Hwang, Young Il Kim, Byoungchul Choi, Chulho Kim
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Published online June 30, 2018
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- 세균성 뇌수막염 환자에서 발견된 두개골결손을 동반한 자발성 공기머리증 1례
- The Prevalence of Dizziness According to Subtypes of Migraine and Factors Related with Daily Disability
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Yerim Kim, Young-Il Kim, Byoungchul Choi, Jong-Hee Sohn, Jong Seok Bae, Ju-Hun Lee, Sang-Hwa Lee
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Published online June 30, 2018
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- 편두통 양상에 따른 어지럼 동반 빈도 및 일상생활 장애와 관련된 임상 요인 분석
- Isolated Dental and Lower-Facial Pain Mimicking Trigeminal Neuropathy: An Indirect Carotid-Cavernous Fistula
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Byoungchul Choi, Chulho Kim, Sung-Hwan Kim, Jong-Hee Sohn
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Received September 30, 2025 Accepted October 12, 2025 Published online October 16, 2025
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DOI: https://doi.org/10.62087/hpr.2025.0020
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Abstract
- Carotid-cavernous fistula (CCF) is a pathological arteriovenous communication in which carotid arterial flow is diverted into the cavernous sinus. Clinical manifestations typically include ocular signs, cranial neuropathies, and headache. Neurologic deficits most commonly reflect involvement of cranial nerves III, IV, V1/V2, and VI within or along the cavernous sinus; in contrast, isolated trigeminal presentations are rare, and V3 involvement is particularly uncommon. A 69-year-old woman presented with isolated V2/V3-territory pain, perceived as molar, gingival, and lower facial discomfort. Her symptoms were initially misattributed to trigeminal neuropathy or dental pathology. Subsequently, she developed horizontal diplopia, and bedside testing localized a right abducens palsy. Brain magnetic resonance imaging revealed findings suspicious for a CCF, which was angiographically confirmed as an indirect CCF. Following embolization, the patient’s pain markedly improved, implicating the CCF as the source of the V2/V3 symptoms. This case highlights that an atypical, trigeminal-predominant onset—even with pain limited to the V2/V3 distribution—may indicate an indirect CCF. When atypical trigeminal neuropathy is suspected and dental or other peripheral causes are excluded, clinicians should consider the possibility of a CCF.
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