[Carotid-cavernous fistula. Diagnosis by angiography and scintillation camera (author's transl)]

Four patients with post-traumatic and one with a spontaneous carotid-cavernous fistula are described. Perfusion scintigraphy made the diagnosis in three patients and in the other two strongly suggested it. Exposures in ventral and lateral projections are able to make the correct diagnosis. Sequential scintigraphy is also valuable for post-operative follow-up. Cerebral angiography can localise the fistula and the adequacy of the circle of Willis can be determined pre-operatively. In addition to the major venous flow from the cavernous sinus into the superior ophthalmic vein, other characteristic pathways may be demonstrated. Knowledge of the pathological and anatomical situation is a prerequisite for treatment planning.