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Cavernous SinusCarotid-Cavernous Sinus FistulaExophthalmosArteriovenous FistulaCavernous Sinus ThrombosisOrbital NeoplasmsFistulaOrbital DiseasesOrbitRespiratory Tract FistulaPyriform SinusThyroiditis, SuppurativeDiplopiaGraves OphthalmopathyCarotid Artery DiseasesCarotid ArteriesCarotid Artery, InternalDura MaterOphthalmoplegiaEmbolization, TherapeuticTomography, X-Ray ComputedCarotid StenosisSphenoid SinusIntestinal FistulaMucoceleOrbital PseudotumorCoronary SinusCranial SinusesCutaneous FistulaCerebral AngiographyParanasal Sinus DiseasesCentral Nervous System Vascular MalformationsEthmoid SinusOrbital CellulitisCarotid SinusBronchial FistulaFrontal SinusVascular FistulaBarium SulfateRectal FistulaAbducens Nerve DiseasesGastric FistulaUrinary FistulaPanophthalmitisGraves DiseaseHemangioma, CavernousEsophageal FistulaEndarterectomy, CarotidPharyngeal DiseasesCranial NervesBiliary FistulaEthmoid SinusitisEye DiseasesBlepharoptosisMagnetic Resonance ImagingSinus Thrombosis, IntracranialCerebral VeinsCranial Fossa, MiddleSkull Fracture, BasilarSphenoid BoneSkull NeoplasmsCarotid Artery, CommonPancreatic FistulaCarotid BodyRectovaginal FistulaMeningiomaAbscessMaxillary SinusRetrobulbar HemorrhageTreatment OutcomeSella TurcicaOculomotor Nerve DiseasesVesicovaginal FistulaOrbital FracturesThyroiditis
Internal carotiArteriovenous fistulasExternal carotiCaroticocavernous fistulaVenousOrbitalChemosisThrombosisArterial bloodPulsatilePituitary glandArteryCongestionOccurIndirectPenetrating head tSecondaryAbnormalOrbitSpontaneousIntracavernousSphenoidClassificationOnsetBranchesCosmeticVisual lossTypeSymptomsTypesHistoryPatients
Internal caroti12
  • 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)
  • 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)
  • 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 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)
  • 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)
  • This type is very difficult to resect because of the absence of the arachnoid plane between the tumor and the internal carotid artery. (medscape.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)
  • They are postulated to occur secondary to cavernous sinus thrombosis with revascularization and thus are similar to dural arteriovenous fistulas elsewhere. (radiopaedia.org)
  • Caroticocavernous fistulas represent approximately 12% of all dural arteriovenous fistulas. (medscape.com)
External caroti2
  • 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)
Caroticocavernous fistula5
  • Type-D caroticocavernous fistula: the eye demonstrates proptosis, chemosis, and scleral edema. (medscape.com)
  • CT angiography is the noninvasive imaging modality of choice for evaluation of suspected caroticocavernous fistula 9 . (radiopaedia.org)
  • 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)
Venous6
  • 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)
  • 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)
  • 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)
  • 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)
Orbital5
  • 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)
  • The orbital involvement of the tumor causes significant proptosis of the affected eye. (medscape.com)
  • Denervation within V2 will confirm the need for emergent non-contrast orbital CT to evaluate for a break in the orbital floor and to discount a hemorrhage within the sinus cavities. (reviewofoptometry.com)
  • ABSTRACT Orbital decompression is widely performed for the management of proptosis for cosmetic and functional cases of Graves orbitopathy. (bvsalud.org)
Chemosis2
  • 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)
Thrombosis1
  • Secondary intracranial hypertension with cerebrovenous sinus thrombosis. (aetna.com)
Arterial blood1
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)
Pituitary gland1
Artery2
  • 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)
  • 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)
Congestion1
  • In cases of indirect carotid-cavernous fistulas, there is moderate ocular congestion, mild proptosis, and ocular pulsation on aplanotonometry. (medscape.com)
Occur1
  • cavernous sinus tuberculoma may occur in the absence of pulmonary findings. (stanford.edu)
Indirect4
  • Spontaneous resolution of indirect fistulae has been reported but is uncommon. (wikipedia.org)
  • 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)
Penetrating head t1
  • 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)
Secondary2
  • [ 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)
Abnormal2
Orbit2
  • Medially, they may expand into the wall of the cavernous sinus, anteriorly into the orbit, and laterally into the temporal bone. (medscape.com)
  • The inferior aspect of the right orbit has been fractured and the maxillary sinus is opacified in this computed tomography scan, which uses both x-rays and sensors to gather data and make soft tissue visible. (reviewofoptometry.com)
Spontaneous4
  • 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)
  • 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)
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)
Sphenoid5
  • Sphenoid wing meningiomas also are known as "orbitosphenoid meningiomas," "meningiomas en plaque of the sphenoid wing," and "sphenoid wing meningiomas with osseous involvement. (medscape.com)
  • Two different growing patterns of sphenoid wing meningioma have been described: meningioma en masse, forming a nodular space-occupying lesion, and meningioma en plaque, which is flat and demonstrates a carpet-like growth pattern. (medscape.com)
  • Lateral orbitotomy approach for removing hyperostosing en plaque sphenoid wing meningiomas. (surgicalneurologyint.com)
  • Sphenoid wing (SW) en plaque meningioma (ePM) is a subgroup of meningiomas defined by its specific character presenting with a rather thin sheath of soft tumor tissue accompanied by disproportionate and extensive bone hyperostosis. (surgicalneurologyint.com)
  • Hyperostosis of the greater and lesser wings of the sphenoid bone leading in progressive proptosis is the main characteristics of ePM in this location. (surgicalneurologyint.com)
Classification1
  • Barrow and associates developed the current classification system of caroticocavernous fistulas in 1985. (medscape.com)
Onset1
  • citation needed] Patients usually present with sudden or insidious onset of redness in one eye, associated with progressive proptosis or bulging. (wikipedia.org)
Branches2
  • Dural CCFs are low-flow fistulas resulting from communications of cavernous arterial branches and the cavernous sinus. (medscape.com)
  • The most frequent are type C, with meningeal branches of the external carotid forming the fistula 3 . (radiopaedia.org)
Cosmetic1
  • Treatment is recommended for intolerable bruit, progressive visual loss, and the cosmetic effects of proptosis. (medscape.com)
Visual loss2
  • Initial results of uncontrolled studies suggested that optic nerve sheath decompression was a promising treatment of progressive visual loss in patients with NAION. (aetna.com)
  • The investigators concluded that optic nerve decompression surgery is not an effective treatment for NAION, and in fact, may increase the risk of progressive visual loss in NAION patients. (aetna.com)
Type5
  • It is a type of arteriovenous fistula. (wikipedia.org)
  • The image below depicts a type D carotid-cavernous fistula. (medscape.com)
  • Type-A fistulas rarely resolve spontaneously. (medscape.com)
  • Type I clinoidal meningiomas originate from the inferomedial surface of the clinoidal process proximal to the distal carotid ring. (medscape.com)
  • 5 20 45 ] Cushing and Eisenhardt[ 13 ] coined the term of "en plaque" for the first time to differentiate this type of tumor growth from those designated as "en mass" meningiomas. (surgicalneurologyint.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)
Types1
  • This is a diagrammatic representation of the 4 types of caroticocavernous fistulas. (medscape.com)
History1
  • We report the case of a 64-year-old male patient with a 5 month history of proptosis, motility limitation and vision loss in OD. (bvsalud.org)
Patients1
  • in fact, significantly more patients in the surgery group had progressive loss of vision than patients who received only careful follow-up. (aetna.com)