Romanian Neurosurgery (Mar 2011)
Direct carotid-cavernous fistula and glaucoma
Abstract
A carotid-cavernous fistula is an abnormal communication between carotid artery system and the cavernous system. The causes that determines the onset of the fistula are trauma or spontaneous. The fistula receives venous blood from the eye and the brain, from the ophthalmic veins and the superficial middle cerebral vein. The abnormal shunt determines raised venous pressure on the cavernous sinus, determining ophthalmic veins stasis. It appear ocular congestion, raised intraocular pressure, exophthalmia, diplopia, decreased visual acuity or cranial nerves paralysis. Glaucoma is a potential complication that appear in carotid-cavernous fistula from increased pressure in the episcleral veins. Carotid-cavernous fistula diagnosis can be determined clinically and imagistically. This pathology is treated successfully in 90% of all cases, the mortality and morbidity rates are very low. This study presents two case reports, diagnosed with direct carotid-cavernous fistula and glaucoma.
