H/O Head Injury followed by exophthalmos
MRI Orbit & Angiography
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MRI shows dilated tortuous left superior ophthalmic vein and dilated cavernous sinus with flow void within. The cavernous sinus does not show any filling defect within on post Gd study. On MRI time of flight angiography, the presence of a high flow communication between the intracavernous portion of the left ICA and the cavernous sinus is seen, establishing the diagnosis of direct caroticocavernous fistula.