External carotiArteriovenous fistulasCaroticocavernous fistulaChemosisVenous systemThrombosisArterialNormal venousPituitary glandSuperior ophtPulsatileSpontaneousArteryCongestionAbnormal communicationConnective tissueOccurOrbitalSecondaryIndirectIntracavernousClassificationInternalOnsetBranchesDirectProgressive visual lossSymptomsCerebralType
External caroti5
- Direct fistulas occur when the Internal Carotid artery (ICA) itself fistulizes into the Cavernous sinus whereas indirect is when a branch of the ICA or External Carotid artery (ECA) communicates with the cavernous sinus. (wikipedia.org)
- The external carotid artery provides several branches to the dura of the cavernous sinus and forms anastomoses with the branches of the internal carotid artery. (medscape.com)
- Type D fistulas are a combination of types B and C, with dural shunts between internal and external carotid artery branches and the cavernous sinus. (medscape.com)
- ECA is the external carotid artery. (medscape.com)
- Results The Neuron 6 F 0.053 inch inner luminal diameter delivery catheter (Penumbra) was placed in a very distal location within the internal carotid artery, external carotid artery and venous system enabling successful endovascular treatment of the intracranial pathology with no related neurological complications. (bmj.com)
Arteriovenous fistulas4
- Selective arteriography is used to evaluate arteriovenous fistulas. (wikipedia.org)
- Case reports of dural arteriovenous fistulas were first published in the 1930s. (medscape.com)
- Caroticocavernous fistulas represent approximately 12% of all dural arteriovenous fistulas. (medscape.com)
- They are postulated to occur secondary to cavernous sinus thrombosis with revascularization and thus are similar to dural arteriovenous fistulas elsewhere. (radiopaedia.org)
Caroticocavernous fistula5
- Type-D caroticocavernous fistula: the eye demonstrates proptosis, chemosis, and scleral edema. (medscape.com)
- A caroticocavernous fistula results in high-pressure arterial blood entering the low-pressure venous cavernous sinus. (medscape.com)
- Blunt and penetrating head injuries can result in a caroticocavernous fistula. (medscape.com)
- A caroticocavernous fistula is not a life-threatening disease. (medscape.com)
- CT angiography is the noninvasive imaging modality of choice for evaluation of suspected caroticocavernous fistula 9 . (radiopaedia.org)
Chemosis4
- Direct carotid-cavernous fistulas are characterized by the triad of pulsatile proptosis, chemosis, and intracranial whistling. (medscape.com)
- There is severe conjunctival congestion, hemorrhagic chemosis, ptosis, and pulsatile proptosis accompanied by a whistling. (medscape.com)
- Ocular manifestations can include ophthalmic venous hypertension and orbital venous congestion, proptosis, corneal exposure, chemosis, and arterialization of episcleral veins, as shown below. (medscape.com)
- Chemosis, periorbital edema, and proptosis have been attributed to venous congestion. (stanford.edu)
Venous system2
- Carotid-cavernous fistula (CCF) is an abnormal communication between the high-pressure carotid arterial system and the low-pressure cavernous venous system (CS). (biomedcentral.com)
- In direct CCF, internal carotid artery (ICA) wall disruption allows high-pressure blood to move into the CS, resulting in short-circuiting of the ICA arterial blood into the venous system of the CS. (biomedcentral.com)
Thrombosis2
- Digital subtraction angiography identified an incomplete thrombosis of the left brachiocephalic vein with retrograde flow in the internal jugular vein, sigmoid sinus, and transverse sinus on the left side. (neurointervention.org)
- Secondary intracranial hypertension with cerebrovenous sinus thrombosis. (aetna.com)
Arterial4
- A carotid-cavernous fistula results from an abnormal communication between the arterial and venous systems within the cavernous sinus in the skull. (wikipedia.org)
- As arterial blood under high pressure enters the cavernous sinus, the normal venous return to the cavernous sinus is impeded and this causes engorgement of the draining veins, manifesting most dramatically as a sudden engorgement and redness of the eye of the same side. (wikipedia.org)
- Dural CCFs are low-flow fistulas resulting from communications of cavernous arterial branches and the cavernous sinus. (medscape.com)
- These vessels branch to provide arterial blood to the nerves and dura of the cavernous sinus and the pituitary gland. (medscape.com)
Normal venous1
- This interferes with normal venous drainage patterns and compromises blood flow within the cavernous sinus and the orbit, as depicted in the diagram below. (medscape.com)
Pituitary gland1
- The CS is a paired structure on either side of the sella, pituitary gland, and sphenoid sinus. (stanford.edu)
Superior opht1
- citation needed] CT scans classically show an enlarged superior ophthalmic vein, cavernous sinus enlargement ipsilateral (same side) as the abnormality and possibly diffuse enlargement of all the extraocular muscles resulting from venous engorgement. (wikipedia.org)
Pulsatile1
- CCF symptoms include bruit (a humming sound within the skull due to high blood flow through the arteriovenous fistula), progressive visual loss, and pulsatile proptosis or progressive bulging of the eye due to dilatation of the veins draining the eye. (wikipedia.org)
Spontaneous8
- The spontaneous dural cavernous fistula which is more common usually results from a degenerative process in older patients with systemic hypertension and atherosclerosis. (wikipedia.org)
- Spontaneous resolution of indirect fistulae has been reported but is uncommon. (wikipedia.org)
- Staged manual compression of the ipsilateral carotid has been reported to assist with spontaneous closure in selected cases. (wikipedia.org)
- Most caroticocavernous fistulas are of spontaneous origin and unknown etiology. (medscape.com)
- Types B, C, and D fistulas have a higher incidence of spontaneous resolution. (medscape.com)
- Direct spontaneous carotid-cavernous fistula (sCCF) is reportedly pathognomonic of vEDS. (biomedcentral.com)
- In vEDS, anatomical and pathophysiological features of the intra-cavernous internal carotid artery make it prone to shunting in the cavernous sinus, due either to a spontaneous rupture or to a spontaneous dissection with pseudoaneurysm formation. (biomedcentral.com)
- It is therefore unsurprising that vEDS has been associated with the development of spontaneous direct carotid-cavernous fistula (sCCF). (biomedcentral.com)
Artery12
- High resolution digital subtraction angiography may help in classifying CCF into dural and direct type and thus formulate a strategy to treat it either by a balloon or coil or both with or without preservation of parent ipsilateral carotid artery. (wikipedia.org)
- citation needed] Direct CCF may be treated by occlusion of the affected cavernous sinus (coils, balloon, liquid agents), or by reconstruction of the damaged internal carotid artery (stent, coils or liquid agents). (wikipedia.org)
- Direct CCFs are high-flow fistulas with a direct connection between the internal carotid artery (ICA) and the cavernous sinus. (medscape.com)
- The cavernous sinus is a network of venous channels traversed by the intracranial portion of the internal carotid artery. (medscape.com)
- The internal carotid artery gives rise to several intracavernous branches. (medscape.com)
- Type A fistulas consist of a direct connection between the intracavernous internal carotid artery and the cavernous sinus. (medscape.com)
- Type B fistulas consist of a dural shunt between intracavernous branches of the internal carotid artery and the cavernous sinus. (medscape.com)
- Indirect CCFs result from a dural branch rupture of the carotid artery caused by a genetic condition or a comorbidity such as hypertension. (medscape.com)
- A direct fistula is due to direct communication between the intracavernous internal carotid artery and the surrounding cavernous sinus. (radiopaedia.org)
- The internal carotid artery (ICA) is the most medial structure and cranial nerves III, IV, and first and second branches of cranial nerve V are located in the lateral wall of the dura. (stanford.edu)
- 38 In otitis media, infection spreads via the sigmoid sinus and along the internal carotid artery plexus. (stanford.edu)
- The postulated mechanisms accounting for visual impairment and blindness in CST include venous infarction of the retina and retinal ischemia caused by occlusion of either an ophthalmic artery branch or the central retinal artery, or by mechanical pressure at the OA. (stanford.edu)
Congestion1
- In cases of indirect carotid-cavernous fistulas, there is moderate ocular congestion, mild proptosis, and ocular pulsation on aplanotonometry. (medscape.com)
Abnormal communication1
- Caroticocavernous fistulas represent abnormal communication between the carotid circulation and the cavernous sinus . (radiopaedia.org)
Connective tissue1
- citation needed] Carotid cavernous fistulae may form following closed or penetrating head trauma, surgical damage, rupture of an intracavernous aneurysm, or in association with connective tissue disorders, vascular diseases and dural fistulas. (wikipedia.org)
Occur1
- cavernous sinus tuberculoma may occur in the absence of pulmonary findings. (stanford.edu)
Orbital2
- Occasionally, more direct approaches, such as direct transorbital puncture of the cavernous sinus or cannulation of the draining superior orbital vein are used when conventional approaches are not possible. (wikipedia.org)
- Infectious CST is typically a complication of a facial, orbital, odontogenic, or paranasal sinus infection. (stanford.edu)
Secondary3
- [ 3 ] Karaman et al reported on a carotid-cavernous fistula secondary to blunt trauma after functional endoscopic sinus surgery. (medscape.com)
- Direct caroticocavernous fistulas are often secondary to trauma, and as such the demographics reflect the distribution of head trauma, most commonly seen in young male patients. (radiopaedia.org)
- We describe a patient who presented neurological manifestations secondary to central venous reflux due to throm botic occlusion of the left BCV. (neurointervention.org)
Indirect3
- citation needed] Indirect CCF may be treated by occlusion of the affected cavernous sinus with coils, liquid agents or a combination of both. (wikipedia.org)
- In contrast, indirect caroticocavernous fistulas have a predilection for the postmenopausal female patient and the onset of symptoms is often insidious. (radiopaedia.org)
- Indirect fistulas are due to communication by multiple branches between the internal and/or external carotid arteries and the cavernous sinus. (radiopaedia.org)
Intracavernous2
- Blunt head injury can lead to shearing of intracavernous arteries, causing the development of a fistula. (medscape.com)
- Penetrating head injury can lead to fistula formation by direct laceration of intracavernous vessels. (medscape.com)
Classification1
- Barrow and associates developed the current classification system of caroticocavernous fistulas in 1985. (medscape.com)
Internal1
- 50% lesion (stenosis or occlusion) in one of the following central veins of the chest: inferior and superior vena cava, brachiocephalic vein (BCV), subclavian vein (SCV), or internal jugular vein (IJV) [ 1 ]. (neurointervention.org)
Onset1
- citation needed] Patients usually present with sudden or insidious onset of redness in one eye, associated with progressive proptosis or bulging. (wikipedia.org)
Branches1
- The most frequent are type C, with meningeal branches of the external carotid forming the fistula 3 . (radiopaedia.org)
Direct2
- Increased carotid circumferential wall stress, higher carotid distensibility and lower carotid intima-media thickness could contribute to a higher risk for direct sCCF in vEDS. (biomedcentral.com)
- Direct sCCF is rare in the general population as most direct fistulas are posttraumatic but seems to be more common in vEDS patients and especially in females. (biomedcentral.com)
Progressive visual loss1
- Treatment is recommended for intolerable bruit, progressive visual loss, and the cosmetic effects of proptosis. (medscape.com)
Symptoms1
- Types B, C, and D tend to be lower-flow and lower-pressure fistulas with a slower progression of signs and symptoms. (medscape.com)
Cerebral1
- A cerebral digital subtraction angiography (DSA) enhances visualization of the fistula. (wikipedia.org)
Type4
- It is a type of arteriovenous fistula. (wikipedia.org)
- The carotid-cavernous fistula (CCF) is a specific type of dural arteriovenous fistula characterized by abnormal arteriovenous shunting within the cavernous sinus. (medscape.com)
- The image below depicts a type D carotid-cavernous fistula. (medscape.com)
- Type-A fistulas rarely resolve spontaneously. (medscape.com)