Coil Embolization of Direct Carotid Cavernous Fistula (CCF)
A 34-year-old female presented with history of right eye proptosis and conjunctival congestion for 2 weeks. She had history of road traffic accident 5 weeks back. MRI brain revealed dilated right ophthalmic vein and prominent right cavernous sinus. DSA (Fig. 61.1a, b) revealed high flow direct CCF filling from the right internal carotid artery (ICA). ICA distal to fistula was not opacified. Venous drainage was through the cavernous sinus into ipsilateral ophthalmic vein and posteriorly into petrosal vein and thereafter into the cerebellar veins. Cortical reflux into the Sylvian veins was also seen.