Early Detection of Dural Carotid-cavernous Fistula (CCF) with Rapidly Aggravating Headache and Cranial Nerve Paresis

Dural carotid cavernous fistulas (CCF) are defined as abnormal communications between the cavernous sinus and one or more internal or external carotid artery branches. When a dural CCF drains posteriorly into inferior or superior petrosal sinus, even typical corkscrew vessels are rarely detected, and the correct diagnosis is not easy. In this report, we present a patient with dural CCF whose initial symptom was rapidly aggravating headache, oculomotor and trigeminal ophthalmic branch paresis without any ocular symptom or sign.