Carotid-cavernous fistula
Encyclopedia
A carotid-cavernous fistula (CCF) results from an abnormal communication between the arterial and venous systems within the cavernous sinus
in the skull. It is a type of arteriovenous fistula
. As arterial blood under high pressure enters the cavernous sinus, the normal venous return to the cavernous sinus is impeded and this causes engorgement of the draining veins, manifesting most dramatically as a sudden engorgement and redness of the eye of the same side.
rupture of an intracavernous aneurysm etc. or in association with connective tissue disorders, vascular diseases and dural fistulas.
(a humming sound within the skull due to high blood flow through the arteriovenous fistula), progressive visual loss, and pulsatile proptosis or progressive bulging of the eye due to dilatation of the veins draining the eye. Pain is the symptoms that patients often find the most difficult to tolerate.
Patients usually present with sudden or insidious onset of redness in one eye, associated with progressive proptosis or bulging.
They may have a history of similar episodes in the past.
Cavernous sinus
The cavernous sinus , within the human head, is a large collection of thin-walled veins creating a cavity bordered by the temporal bone of the skull and the sphenoid bone, lateral to the sella turcica.-Contents:...
in the skull. It is a type of arteriovenous fistula
Arteriovenous fistula
An arteriovenous fistula is an abnormal connection or passageway between an artery and a vein. It may be congenital, surgically created for hemodialysis treatments, or acquired due to pathologic process, such as trauma or erosion of an arterial aneurysm....
. As arterial blood under high pressure enters the cavernous sinus, the normal venous return to the cavernous sinus is impeded and this causes engorgement of the draining veins, manifesting most dramatically as a sudden engorgement and redness of the eye of the same side.
Causes
Carotid cavernous fistulae may form following closed or penetrating head trauma, surgical damage,rupture of an intracavernous aneurysm etc. or in association with connective tissue disorders, vascular diseases and dural fistulas.
Classification
Many types of classification have been proposed for CCF, based on the anatomy, pathophysiology and aetiology. They may be divided into low-flow or high-flow, traumatic or spontaneous and direct or indirect. One of the most popular classifications divides CCF into four varieties depending on the type of arterial supply.| Type | Description |
|---|---|
| A | Fistulous supply from the internal carotid artery Internal carotid artery In human anatomy, the internal carotid arteries are two major arteries, one on each side of the head and neck. They arise from the common carotid arteries where these bifurcate into the internal and external carotid artery, and they supply the brain.... |
| B | Supply from the dural branches of internal carotid artery |
| C | Supply from the dural branches of external carotid artery External carotid artery In human anatomy, the external carotid artery is a major artery of the head and neck. It arises from the common carotid artery when it bifurcates into the external and internal carotid artery.-Course:... |
| D | Combined forms |
Symptoms and presentation
While CCF is not a lethal disease, its symptoms can be disabling and include bruitBruit
Bruit is the term for the unusual sound that blood makes when it rushes past an obstruction in an artery when the sound is auscultated with the bell portion of a stethoscope.The term "bruit" simply refers to the sound...
(a humming sound within the skull due to high blood flow through the arteriovenous fistula), progressive visual loss, and pulsatile proptosis or progressive bulging of the eye due to dilatation of the veins draining the eye. Pain is the symptoms that patients often find the most difficult to tolerate.
Patients usually present with sudden or insidious onset of redness in one eye, associated with progressive proptosis or bulging.
They may have a history of similar episodes in the past.
External links
- Carotid Cavernous Fistula Radiology Images from MedPix