External Carotid-Facial Vein Fistula Masquerading as Carotid-Cavernous Fistula

Carotid-cavernous sinus fistulas(CCFs)are abnormal communications between the internal or external carotid arteries and the cavernous sinus, and are typically classified as direct(high flow) or indirect(low flow) Here we describe a patient whose presentation mimicked an indirect CCF(connection between pericavernous dural arterial branches and cavernous venous plexus), but instead was found to have a fistula between both the facial and internal maxillary arteries and his facial vein.