PMC6417300_01
(a) Prominent right superior ophthalmic vein and bilateral enlarged cavernous sinuses with multiple flow voids adjacent to internal carotid arteries with flow related enhancement in time-of-flight magnetic resonance angiography. (b) - Digital subtraction angiography showed right cavernous fistula with multiple rents in laceral and cavernous segments of right internal carotid artery. (c) - Coil mass inside right cavernous and proximal petrous internal carotid artery. (d) - complete obliteration of fistula and flow beyond right petrous internal carotid artery in subsequent check angiogram
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F1
Magnetic resonance imaging of the brain showed mildly prominent right superior ophthalmic vein and bilaterally enlarged cavernous sinuses with multiple flow voids adjacent to internal carotid arteries (ICAs) and flow-related enhancement in time-of-flight magnetic resonance angiography suggestive of carotid-cavernous fistula (CCF) [Figure 1a]. Digital subtraction angiography showed right CCF with multiple rents in laceral and cavernous segments of right ICA [Figure 1b]. Squid18 into the coil mass [Figure 1c]. Subsequent check angiogram revealed complete obliteration of fistula and flow beyond right petrous ICA [Figure 1d]. She improved clinically and after 2 weeks only had mild diplopia looking to the right.