Carotid-Cavernous Fistula

Question 1

What is a carotid-cavernous sinus fistula?

Answer 1

An abnormal communication between the internal carotid artery and the cavernous sinus

Question 2

What is the most common cause of CCF?

Answer 2

Closed head trauma

Question 3

Classically, what may spontaneously cause a CCF?

Answer 3

Ruptured internal carotid artery aneurysm

Question 4

What is occurring during a CCF?

Answer 4

High pressure blood from the carotid artery builds up in the cavernous sinus and impedes the return of venous blood back to the cavernous sinus

Question 5

What is the clinical triad of CCF?

Answer 5

Chemosis
Pulsatile proptosis
Ocular bruit

Question 6

Why does chemosis occur in CCF?

Answer 6

Blood backflows from the cavernous sinus into the episcleral veins

Question 7

A CCF may cause palsies of what nerves? Why?

Answer 7

CN: 3, 4, 6, V1, V2

They all run in the cavernous sinus

Question 8

What nerve(s) run(s) in the lateral wall of the cavernous sinus?

Answer 8

CN: 3, 4, V1, V2

Question 9

What nerve(s) run(s) inside the cavernous sinus?

Answer 9

CN 6

Question 10

What are the 5 most common signs of CFF?

Answer 10

Chemosis
Pulsatile proptosis
Ocular bruit
Episcleral venous congestion
Elevated IOP