PMC5442449_01
Slit lamp photograph of the left eye showing periorbital edema, conjunctival edema and chemosis, dilated cork-screw vessels and corneal mucous plaques (arrow) on the superior half of the cornea.
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F1
In the left eye, there were conjunctival congestion and chemosis associated with dilated episcleral vessels, with few mucous plaques on the superior half of the cornea (Figure 1 (Fig. 1)).
Digital subtraction angiography, antero-posterior view, left sided. Pooling of contrast material in the cavernous sinus with a direct communication (arrow) between the internal carotid artery and the cavernous sinus is seen, suggestive of Barrow's type A carotid cavernous fistula.
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F2
Digital subtraction angiography (DSA) was subsequently ordered. 4-vessel DSA revealed a high flow CCF Barrow's type A (Figure 2 (Fig. 2)).
Digital subtraction angiography, lateral view, left sided. A coiling material and balloon (arrow) seen completely obliterating the fistula with no extravasation of the contrast agent. No feeding remnant is present.
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F3
Two weeks later, he underwent a successful angioembolization (Figure 3 (Fig. 3)).