ABSTRACT A carotid-cavernous fistula (CCF) results from an abnormal vascular shunt between the carotid artery and the venous channels of the cavernous sinus. The clinical presentation varies based on the involved neurovascular structures, the anatomy of the shunt, the underlying cause, and the hemodynamics of the CCF. In this case report, we describe a 46-year-old man who presented with recurrent headaches, redness, bulging, and a rapid decline in vision in his right eye, along with diplopia. Brain magnetic resonance imaging revealed dilation of the superior ophthalmic vein. A subsequent digital subtraction angiogram confirmed a Barrow classification Type D (indirect) CCF. The patient underwent endovascular therapy involving combined coil and Onyx™ embolization (a mixture of ethylene-vinyl alcohol copolymer, dimethyl-sulfoxide, and micronized tantalum powder from Medtronic, USA) intervention resulting in an exceptional angiographic and clinical outcome. The patient became entirely symptom-free within 2 weeks following the treatment.
Dalai et al. (Mon,) studied this question.
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