Abstract
Carotid-cavernous fistulas are abnormal communications between the internal or external carotid artery or one of its branches (arterial system) and the cavernous sinus (venous system). The spectrum of presentation of this entity is very variable. However, patients may consult for headache and symptoms derived from orbital congestion such as proptosis, chemosis, orbital murmurs and loss of vision. They require timely diagnosis and treatment. We present the case of a 60 year old patient with a history of acute orbital myositis, carotid-cavernous fistula in the right eye, paralysis of the sixth left cranial nerve and a 2 month old headache who consults for binocular diplopia, bilateral ocular pain, conjunctival injection, purulent secretion outflow, bilateral epiphora, sensation of hallucination of movement with gait and photophobia. Cerebral panangiography reports remnant of Barrow's b-type indirect carotid-cavernous fistula by right and left meningohypophysis trunks. The pacient taken to endovascular therapy with successful fistula obliteration.
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