Presentation
Blurring of vision and chemosis in left eye.
Patient Data
Age: 42
Gender: Male
From the case:
Caroticocavernous fistula
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There is dilatation and enhancement of the left superior ophthalmic vein as well as sphenoparietal sinus. There is also enhancement of the left cavernous sinus in this arterial phase scan in keeping with caroticocavernous fistula. No proptosis is evident.
Case Discussion
Caroticocavernous fistulas (CCF) represent abnormal communication between the carotid circulation and the cavernous sinus. They can be classified as direct or indirect which are separate conditions with different etiologies. Clinical presentations:
- pulsatile exophthalmos/proptosis: ~75% 3
- chemosis and subconjunctival hemorrhage
- progressive visual loss: 25-32% 3
- pulsatile tinnitus (usually objective)
- raised intracranial pressure
- subarachnoid hemorrhage, intracerebral hemorrhage, otorrhagia, epistaxis: ~ 5.5% 3
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