A carotid-cavernous fistula refers to a connection that develops between the segment of the carotid artery that passes through the cavernous sinus and the cavernous sinus itself. The carotid enters the cavernous sinus just before entering the brain. The cavernous sinus is a cavity formed by the linings of the brain. It is a conduit for venous blood draining back to the heart from the brain. In addition, a number of cranial nerves that supply the muscles that move the eyes and ones that supply sensation to the face pass through positions of the cavernous sinus. The blood draining from the eye also passes to the cavernous sinus. When an aneurysm, or weakened area of the artery occurs in the cavernous sinus, it may rupture, leading to a direct connection between the carotid artery and the sinus. Also, trauma may tear the artery producing a carotid-cavernous fistula.
Causes of Carotid-cavernous Fistula
The cause of a carotid-cavernous fistula is either an aneurysm or trauma. In either case, a small opening or hole develops in the cavernous portion of the carotid artery. This allows the blood under high pressure to be directly transmitted to the cavernous sinus. The symptoms which arise are the result of this increased pressure within the cavernous sinus.
Signs and Symptoms of Carotid-cavernous Fistula
In response to the increased pressure in the cavernous sinus, the eyeball bulges outwards, pulsates and has engorged veins. There is usually double vision caused by the eyeball being displaced and the nerves within the cavernous sinus being damaged. There may be decreased vision due to increased pressures within the eyeball. Headache and eye pain may occur. Portions of the trigeminal nerve pass through the cavernous sinus and may also be affected leading to numbness in the upper portions of the face.
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Medical Content Last Updated on 07/12/2008
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