Sunday 11 September 2011

Carotico cavernous fistula (CCF)

A 48 y o male, bilateral Orbital Pulsatile Proptosis marked on left side with conjunctival congestion.
MRI Brain Axial T2w images, Digital Substraction Angiography and Axial CT section. 
MRI Brain Axial T2w images shows abnormal T2 flow voids in the region of cavernous sinus on either side. Abnormal dilatation of bilateral superior ophthalmic veins marked on left side suggestive Carotico cavernous fistula.
DSA 1st image : Right side Carotid injection demonstrates the fistula, direct contrast filling of bulky bilateral cavernous sinuses from right ICA cavernous portion. 2nd image : Left side Carotid injection shows normal left ICA - ACA and MCA. 3rd image : E/o coiling of fistula through right side ICA (done by Dr Shirish Valsangkar, in our institute).
Post procedure follow up CT shows streak artefact due to coiling.
Complications nil.

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