Angiographic patterns of carotid-cavernous fistulas

Full text: The aim of the study is to present our experience in angiographic evaluation of carotid-cavernous fistulas. 8 patients with carotid-cavernous fistula (6 men and 2 women, range of age from 15 to 62) are included in the study out of all undergone cerebral angiography for a four year period (1996 - 2000). All patients underwent CT brain examination, two out of 8 - MRI. Visualization of ipsi- and contra lateral cavernous sinus and ophthalmic vein dilatation are assessed. In all cases the communication between the internal carotid artery and the cavernous sinus has been assessed as direct. Near simultaneous visualization of the home internal carotid artery, the dilated ipsilateral cavernous sinus and dilated superior ophthalmic vein is found in 2 patients, simultaneous visualization of both cavernous sinuses - in two. In 1 patient the early visualization of the cavernous sinus through the fistula enabled visualization of ipsilateral main internal carotid artery from the contra lateral circulation through the communicating arteries.In 1 excessive contralateral cavernous sinus and contralateral superior ophthalmic vein dilatation is detected. In other 1 excessive flow to dilated ipsilateral cavernous sinus lead insufficient circulation in distal vessels. Digital subtraction Angiography remains the most suitable imaging method in carotid-cavernous fistula assessment regarding type of communication and level of following vessels morphology changes