Carotid Cavernous Fistulas

A CCF can raise the pressure in the cavernous sinus and affect nearby nerves that control eye movements and some sensations in parts of the head and face. It can also affect the veins that drain the eyes. CCFs are one of the causes of “red eye” and other visual problems.  

If left untreated, vision loss can occur. Other symptoms can include: 

• Conjunctivitis (pink eye) symptoms 
• Hearing a rumbling, buzzing or swishing sound, known as a bruit 
• Double vision 
• Eye pain or pressure
• Red or bulging eye (proptosis) that may pulse 

After a discussion about your symptoms and medical history, your neurologist will perform a physical exam and an eye exam. Other imaging scans that evaluate your eye, nearby blood vessels and cavernous sinus area include: 

• Computerized tomography (CT) scan 
• Magnetic resonance imaging (MRI) 
• Ultrasound 
  
  

Based on the results of your exams, we will determine whether your CCF is one of two types: 

There are two types of carotid-cavernous sinus fistulas: 

• Direct, which usually results from a torn carotid artery. This type is often caused by head trauma. Between 70 and 90% of direct CCFs are caused by injury to the base of the skull. 
• Indirect, which can occur spontaneously, due to a connective tissue disorder or as a result of a ruptured aneurysm or atherosclerotic arteries. Indirect CCFs occur more often in postmenopausal women who have high blood pressure.