Dural carotid-cavernous fistula successfully treated by embolization via inferior ophthalmic vein Case report

Abstract

Spontaneous dural carotid-cavernous fistulas (dural CCFs) usually have an indolent course, low morbidity, and a high rate of spontaneous resolution. Surgical treatment should therefore be avoided, if possible. However, we encountered a patient with prominent venous drainage, diplopia, intolerable orbital pain, and headache. The SOV in this patient was tortuous and partly stenotic, while the inferior ophthalmic vein (IOV) was dilated but neither tortuous nor stenotic. The patient was successfully treated by embolization via this vein without complication. To our knowledge, embolization of the cavernous sinus with dural CCFs through the IOV for dural shunt syndrome has not been previously reported.