Computed tomography of carotid-cavernous fistula

• Published in: American journal of neuroradiology : AJNR Vol. 4; no. 2; pp. 131 - 136
• Main Authors: JAMSHID AHMADI, TEAL, J. S, SEGALL, H. D, CHI-SHING ZEE, JONG-SUK HAN, BECKER, T. S
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL American Society of Neuroradiology 01-01-1983
• Subjects: Adult; Aged; Arteriovenous Fistula - diagnostic imaging; Arteriovenous Fistula - etiology; Biological and medical sciences; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - etiology; Cavernous Sinus - diagnostic imaging; Cavernous Sinus - injuries; Female; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Male; Medical sciences; Middle Aged; Tomography, X-Ray Computed; Traumas. Diseases due to physical agents; Human; Eye disease; Nervous system diseases; Arteriovenous aneurysm; Exophthalmus; Radiodiagnosis; Carotidocavernous; Craniocerebral; Brain (Vertebrata); Computerized axial tomography; Trauma
• ISSN: 0195-6108; 1936-959X

Fourteen patients with angiographically-proven carotid-cavernous fistulas were evaluated by computed tomography (CT). Unilateral or bilateral exophthalmos was noted in 12 patients. Slight blurring of the margin of the globe was present in two, presumably due to pulsations of the globe or conjunctival edema. Superior ophthalmic veins were prominent in 12 patients and were often larger on the side of the fistula. Irregularity or absence of contrast enhancement of the superior ophthalmic vein may indicate partial or complete thrombosis. Focal bulging or diffuse distention of the cavernous sinus was noted in nine patients. Enlargement of the extraocular muscles was observed in seven with swelling of the eyelids and edema of the conjunctiva in eight patients. The pattern of venous drainage, type of fistula, and time intervals between trauma, commencement of fistula, and CT scan may affect the CT manifestations of carotid-cavernous fistulas.