Carotid-cavernous Fistula (Kennerdell Case 26, PPT)

History: A 58-year-old woman presented with a two week history of left proptosis, visual disturbance and erythema and edema of the left upper lid. She was found to have dilated aterialized conjunctival veins and an elevated intraocular pressure at 35 in the left eye. Anatomy: Entire superior ophthalmic vein; Eyelid. Clinical: Dilated materialized conjunctival veins and an elevated intraocular pressure at 35 in the left eye. Presenting Symptom: Left proptosis, visual disturbance and erythema and edema of the left upper lid. Disease Diagnosis: Carotid-cavernous sinus fistula. Neuroimaging: Ultrasonic appearance of the dilated superior orbital vein on B & A scan. Pathology: A very dilated sausage-like left superior ophthalmic vein noted easily in the left superior aspect of the angiogram. Treatment: Injection of coagulant-coated tiny coils into the fistula.