Related Experiment Video
Updated: Jan 29, 2026

A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail
Published on: February 3, 2016
Carotid-cavernous fistula(CCF) presenting as paroxysmal painful ophthalmoplegia
Shan Li1, Bin Feng2, Yabo Feng1
1Department of Neurology, Shandong Provincial Hospital affiliated to Shandong University, No 324, Jingwu Road, Huaiyin Zone, Jinan, Shandong Province, 250012, People's Republic of China.
Background:
Painful ophthalmoplegia can be caused by various etiologies, and broad differential diagnosis is needed. Carotid-cavernous fistula (CCF) is a rare cause of painful ophthalmoplegia, and early diagnosis is quite difficult.
Case Presentation:
Here, we present a case of paroxysmal painful ophthalmoplegia caused by CCF. The episodic symptoms were nonstereotypical and lasted minutes to hours. Magnetic resonance imaging (MRI) and computed tomography angiography (CTA) results were normal, which confounded efforts to determine a diagnosis. Subsequently, digital subtraction angiography (DSA) revealed a posterior-draining CCF. The CCF was treated at an early stage without residual symptoms.
Conclusions:
We propose that symptoms could be relapsing or remitting during an early stage of CCF and that posterior-draining CCF is prone to misdiagnosis due to atypical manifestations. Normal CTA results cannot exclude carotid-cavernous fistula, and DSA should be performed once CCF is suspected.
Related Concept Videos
Pain
Analgesia and Pain Management
Primary Motives: Sleep, Sex, and Pain Avoidance
Sleep is a fundamental physiological drive that fosters a state of restfulness crucial for several bodily functions. It facilitates body restoration, the process by which the body repairs, rejuvenates, and maintains itself during sleep, including memory...
Anatomy of the Circulatory System
Biodiversity and Human Values
What is a Sensory System?

