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Dilated Superior Ophthalmic Vein/Asymmetric Cavernous Sinus Enhancement
A 76-year-old woman presenting with diplopia, left-sided visual loss, left eye ptosis, and exophthalmos. Ax, axial; Cor, coronal; CT, computed tomography; CTA, CT angiography.
A 51-year-old woman presenting with headache and swelling of the left eye. Ax, axial; Cor, coronal; CT, computed tomography; CTA, CT angiography.
DESCRIPTION OF FINDINGS
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Case A: Noncontrast head CT in the coronal plane demonstrates enlargement of the left superior ophthalmic vein. Head CT angiography demonstrates arterial phase contrast filling of the cavernous sinus with filling of the enlarged left superior ophthalmic vein. A left common carotid angiogram demonstrates a fistulous connection between the cavernous segment of the ICA with contrast filling and distending of the superior ophthalmic vein in a retrograde fashion.
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Case B: Noncontrast head CT in the coronal plane demonstrates enlargement of the left superior ophthalmic vein. Contrast-enhanced head CT demonstrates thrombus within the left cavernous sinus extending into the left superior ophthalmic vein.
Diagnosis
Case A
Carotid-cavernous fistula (CCF)
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