Carotid-Cavernous Sinus Fistula

The first true pathological nature of an arteriovenous fistula was recognized by William Hunter in 1757. His observation of fistula development when both an artery and vein are simultaneously damaged provided the basis for our present day understanding of A-V fistulas. The abnormal communication between the artery and vein expands as more blood is diverted through less resistant venous channels. Cavernous sinus fistula are probably pathologically different from those arising elsewhere. The cavernous sinus is the only site within the body where a major artery passes through a venous structure. The incidence of C-C fistulas is difficult to establish; primarily because most of them go either unrecognized or are asymptomatic and resolve spontaneously. The two types of c-c fistula behave quite differently in their clinical presentation.