Venous ischemia secondary to drainage constriction in a carotid-cavernous arteriovenous fistula

Abstract

Indirect carotid cavernous arteriovenous fistulas (CCF) are the esult of abnormal communications between meningeal branches f the carotid artery and the cavernous sinus. CCFs that drain anteiorly commonly present with ocular findings such as chemosis r proptosis, whereas those that drain posteriorly often present ith less obvious symptomatology [1]. A change in arteriovenous ynamics in patients with dural AV fistula (dAVF) can lead to retrorade drainage through leptomeningeal veins, which may cause ntracranial hemorrhage or venous ischemia or infarction, with nnual mortality rates up to 10% [2]. This report describes the case f a patient with a posteriorly draining CCF that had documented onstrictionofvenousdrainage resulting invenous ischemia,which ompletely reversed after endovascular treatment.