[Spontaneous carotid-cavernous fistula: angiogammagraphic findings and computer analysis (author's transl)]

The case of a 74-year-old woman with a carotid-cavernous fistula is reported. She was admitted to hospital with oliguria and generalized edema. After improvement of the edematous condition she suddenly presented intense, pulsatile, frontal cephalea. It was more intense on the right side and was accompanied by nausea and vomiting and swelling of the right eye with reddening, sharp pains, difficulty of movement, and loss of vision. Cerebral angiogammagraphy was practiced in anterior-posterior and right lateral view. A righ carotid-cavernous fistula was discovered with drainage through the superior ophthalmic vein and the deep venous system. The angiogammagraphic findings can be considered characteristic; it is important to obtain activity/time curves from various areas of interest in order to evaluate the degree of shunting and the pathway of drainage from the fistula. There was a good coorelation with the arteriographic findings. Eight cases of carotid-cavernous fistulas diagnosed with radionuclids have been published previously, though the activity/time curves were not determined by computer for any of them.