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Traumatic Carotid Cavernous Fistula
Surjith Vattoth, MD, FRCR; Anne G. Osborn, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Carotid cavernous fistula (CCF)
              • Synonyms

                • Direct CCF, high-flow CCF
              • Definitions

                • Single-hole tear/transection of cavernous internal carotid artery (ICA) → arteriovenous shunt into cavernous sinus (CS)

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Angiographic Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              CLINICAL ISSUES

                              • Presentation

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      • Reporting Tips

                                        Selected References

                                        1. Iampreechakul P et al: Spontaneous resolution of direct carotid-cavernous fistulas: case series and literature review. Interv Neuroradiol. 25(1):71-89, 2019
                                        2. Shim HS et al: Delayed contralateral traumatic carotid cavernous fistula after craniomaxillofacial fractures. Arch Craniofac Surg. 20(1):44-7, 2019
                                        3. Zhu L et al: Post-traumatic right carotid-cavernous fistula resulting in symptoms in the contralateral eye: a case report and literature review. BMC Ophthalmol. 18(1):183, 2018
                                        4. Chi CT et al: Direct traumatic carotid cavernous fistula: angiographic classification and treatment strategies. Study of 172 cases. Interv Neuroradiol. 20(4):461-75, 2014
                                        5. Aralasmak A et al: Venous drainage patterns in carotid cavernous fistulas. ISRN Radiol. 2014:760267, 2014
                                        6. Yu Y et al: Use of onyx for transarterial balloon-assisted embolization of traumatic carotid cavernous fistulas: a report of 23 cases. AJNR Am J Neuroradiol. 33(7):1305-9, 2012
                                        7. Vattoth S et al: Magnetic resonance angiographic demonstration of carotid-cavernous fistula using elliptical centric time resolved imaging of contrast kinetics (EC-TRICKS). Magn Reson Imaging. 25(8):1227-31, 2007
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Carotid cavernous fistula (CCF)
                                                    • Synonyms

                                                      • Direct CCF, high-flow CCF
                                                    • Definitions

                                                      • Single-hole tear/transection of cavernous internal carotid artery (ICA) → arteriovenous shunt into cavernous sinus (CS)

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Angiographic Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Image Interpretation Pearls

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Iampreechakul P et al: Spontaneous resolution of direct carotid-cavernous fistulas: case series and literature review. Interv Neuroradiol. 25(1):71-89, 2019
                                                                              2. Shim HS et al: Delayed contralateral traumatic carotid cavernous fistula after craniomaxillofacial fractures. Arch Craniofac Surg. 20(1):44-7, 2019
                                                                              3. Zhu L et al: Post-traumatic right carotid-cavernous fistula resulting in symptoms in the contralateral eye: a case report and literature review. BMC Ophthalmol. 18(1):183, 2018
                                                                              4. Chi CT et al: Direct traumatic carotid cavernous fistula: angiographic classification and treatment strategies. Study of 172 cases. Interv Neuroradiol. 20(4):461-75, 2014
                                                                              5. Aralasmak A et al: Venous drainage patterns in carotid cavernous fistulas. ISRN Radiol. 2014:760267, 2014
                                                                              6. Yu Y et al: Use of onyx for transarterial balloon-assisted embolization of traumatic carotid cavernous fistulas: a report of 23 cases. AJNR Am J Neuroradiol. 33(7):1305-9, 2012
                                                                              7. Vattoth S et al: Magnetic resonance angiographic demonstration of carotid-cavernous fistula using elliptical centric time resolved imaging of contrast kinetics (EC-TRICKS). Magn Reson Imaging. 25(8):1227-31, 2007