title: Direct carotid-cavernous fistula presenting with minimal symptoms and rapid angiographic progression.
abstract: Most patients with direct carotid-cavernous fistulas (CCFs) present with dramatic symptoms including proptosis, chemosis, and diplopia. We report a patient with a direct/high-flow CCF whose only initial symptom was pulse-synchronous tinnitus. Following diagnostic angiography, she developed mild symptoms and dramatic angiographic changes over a period of 3 days. Complete occlusion of the CCF and resolution of her symptoms were achieved by performing a stent-assisted coil embolization.
authors.affiliation: Department of Neurosurgery, University of Iowa Hospital and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA.
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Albert
authors.forename: Nader S
authors.initials: NS
authors.lastname: Dahdaleh
authors.forename: David M
authors.initials: DM
authors.lastname: Hasan
mesh_terms: D020216:Carotid-Cavernous Sinus Fistula / Q000000981:diagnostic imaging* / Q000601:surgery; D002533:Cerebral Angiography / Q000379:methods; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D013997:Time Factors