[A case of bilateral spontaneous external carotid-cavernous fistulae with intrahepatic gallbladder (author's transl)]

A 55-year-old female presented bilateral external ophthalmoplegias and a hypesthesia in the left face and then an intracranial bruit, bilateral conjunctival injections and bilateral chemosis. In her past history, there were right retinal hemorrhage, diabetes mellitus and hypertension but no cranial trauma. The arteriographical aspects were almost identical in both sides: selective external carotid arteriography revealed an opacification of the cavernous sinus through the ascending pharyngeal artery, the accessory meningeal artery and the middle meningeal artery, but the internal carotid arteries and the vertebral arteries did not participate in these fistulae. The association in our case of spontaneous external carotid-cavernous fistulae with intrahepatic gallbladder derived from a developmental arrest in the early stage of embryonic life suggests that spontaneous external carotid-cavernous fistula is derived from communications between extra-cranial vessels and the sinuses in the early stage of embryonic life.