Carotid Cavernous Fistula

Question 1

A Carotid cavernous fistula (CCF) results from abnormal communication between previously normal carotid artery and cavernous sinus. What is the most common cause of a CCF accounting for 70-90% of cases?

1 - basal skull fracture

Answer 1

1 - basal skull fracture

Causes a tear in the internal carotid artery

Question 2

A Carotid cavernous fistula (CCF) presents with all of the following EXCEPT which one?

1 - red eye
2 - proptosis/exophthalmos
3 - complete ophthalmoplegia
4 - ptosis

Answer 2

4 - ptosis

Question 3

A Carotid cavernous fistula (CCF) results from abnormal communication between previously normal carotid artery and cavernous sinus. This is commonly caused by trauma, leading to the internal carotid artery bleeding into the cavernous. Does this increase of decrease venous flow?

Answer 3

• decreases venous flow

Causes dilation of the episcleral blood vessels and causes red eye appearance

Question 4

A Carotid cavernous fistula (CCF) causes:

• impaired venous blood flow
• dilation of episcleral blood vessels
• red eye appearance

The dilation of episcleral blood vessels causes proptosis/exophthalmos that pushes the eye against the orbit. Is eye movement affected in a CCF?

Answer 4

• yes

complete ophthalmoplegia can occur if there is sufficient proptosis

Question 5

Which 2 imaging techniques must be performed in order to identify the cause in carotid cavernous fistula (CCF)?

1 - CT
2 - MRI
3 - CT angiography
4 - PET scan

Answer 5

1 - CT

3 - CT angiography