Carotid - Cavernous Fistula - CCF

Carotid-cavernous fistulas are a rare vascular disorder resulting from an abnormal connection between the cavernous sinus and the carotid arteries. Direct carotid-cavernous fistulas require endovascular treatment. Indirect fistulas may resolve spontaneously or with non-invasive treatment, but worsening symptoms may also require endovascular treatment. Endovascular treatment is performed using detachable balloons, detachable coils, stents, and embolization materials such as n-BAC or Onyx. The symptoms occur as a result of increased pressure within the venous drainage vessels. The most common clinical manifestation are symptoms within the eyeball. Due to their rare occurrence and often non-uniform clinical symptoms, carotid-cavernous fistulas may pose diagnostic difficulties. The Aim of this work: Carotid-cavernous fistula is a disorder that may result in complete loss of vision. Appropriate diagnostics and the involvement of an interdisciplinary team of specialists are important. Such a team should consist of an ophthalmologist, a radiologist and a neurosurgeon. The fistula requires differentiation from other more common diseases with similar symptoms, hence the knowledge of the etiology, diagnosis and treatment of the fistula is crucial. Methods: Selected articles from Pubmed and specialist literature were analyzed in detail. We focused on selected issues related to carotid-cavernous fistulas. Conclusion: When the clinical symptoms are vague, the diagnosis may be incorrect or established with a long delay. Early correct diagnosis can effectively prevent irreversible vision impairment.