Unusual Acute Complication Of Carotid Cavernous Fistula Fong Y Tsai,MD FACR UCI Medical Center, Orange,Ca. USA

Clinical Symptoms Upon Of Size,Site,Duration and Venous drainages: Slowly Worsen as increasing Arterial Shunting and Venous Pressure

Acute Complication Rarely reported,usally during therapeutic procedure Increased Intracranial pressure from shunting of petrosal sinus into sigmoid sinus Subarachnoid hemorrhage from varix of cavernous sinus

Case Report 28/M acute headache and vomiting,head trauma 5 years ago

Cerebral Venous System Cerebral Venous system is so varied Venous drainages of CC fistula may be impaired and induced venous hypertension and increased intracranial pressure

Case report 48/M suffered head trauma from a fall with multiple facial and C2 fractures and through left carotid canal. He had epistaxis from left orbital and nasal injury.

Embolization For Right Epistaxis

Jugular Vein Stenosis

Follow-Up CT 3 Days Later

Case Report 58/M suffered head trauma from MVA with multiple skull fractures with Pneumocephaly, SAH and small SDH

Follow-Up CT 5 days Later and Coma

Case Report 44/F recovered from severe MVA,she had increased ecchymosis,exophathalmos and severe eye pain. Acute hemorrhage of left eye

CT Of Orbit

Case Report 36/F presented with swelling, exophathalmos and ecchymosis of left eye. She experienced significant pulsatile tinnitus for 2 years

Increasing Headache

Case Report 60/F presented with Protosis and edema of right eye with double vision No bruit was noted

Stenosis of Distal Jugular Vein

New Right Ear Bruit

Spontaneous Resolution

Venous Drainages AV Shuntings are important for symptoms of CC fistulas Venous drainages may be important for management of CC fistulas Impaired venous drainages may induce venous hypertension and acute complications

Venous hypertension CC Fistula may induce venous hypertension from AV shunting and outlet obstruction Venous hypertension leads to venous congestion with hemorrhage and dural sinus fistula and venous occlusion.

Thanks For Attention Thank you for the opportunity to present my experience