# @eyebrainear on Instagram

- **Type:** Image
- **Original URL:** https://www.instagram.com/p/BzBb8lOH-Sd
- **Gondola URL:** https://gondola.cc/posts/59967596-eyebrainear-instagram
- **Thumbnail:** https://img.gondola.cc/tr:w-,h-,fo-auto/postThumbnails/137dedc295.jpg
- **Posted:** 2019-06-22T18:40:47.000+00:00
- **Account Owner:** Kemar E. Green (@eyebrainear) — https://gondola.cc/eyebrainear

## Caption

A case of carotid-cavernous fistula (CCF) with the classic corkscrew conjunctival vessels and mild chemosis 🧠👁. 📸 courtesy of Dr. Mangayarkarasi Thandampallayam Ajjeya Gowder (mangaikishore).
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A CCF is an abnormal communication between the venous cavernous sinus and the carotid artery. It may occur spontaneously but usually occurs following some sort of head trauma. There are four distinct types of fistulas (types A-D). A type A fistula is a direct, (high flow fistula) between the cavernous internal carotid artery and the cavernous sinus. It is the most common CCF following head trauma. The onset of symptoms with a Type A fistula is usually rapid and can be very dramatic. Patients with a direct Type A fistula generally present with varied complaints, including unilateral visual loss, proptosis, lid swelling, pulsatile tinnitus and/or diplopia. A triad of clinical findings has been described as exophthalmos, orbital bruit, and dilated conjunctival vessels. Once a direct CCF is identified it is important to direct the patient to the appropriate treating specialist, either an interventional neurologist or neurosurgeon. Direct fistulas always require treatment. Type B-D, or indirect fistulas, occur between meningeal branches of the external or internal carotid artery and the cavernous sinus. These are low-flow fistulas. The etiology of types B-D is unclear, but they have been associated with pregnancy, sinusitis, age, and trauma. Symptoms are usually mild and may include dilated conjunctival and episcleral vessels and mild proptosis. These low flow fistulas generally resolve without treatment.
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#eye #brain #eyeexam #redeye #corkskewvessel #ophthalmology #oftalmologia #oftalmología #ophtalmologie #vision #sight #cavernoussinus #neurology #neurología #neurologie #neurologia #neuroophthalmology #neuroophtho #ccf #medicine #doctor #residency #medicalschool #emergency #eyeemergency #medicalcase #caseoftheday #theeyeshaveit

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## Tags

neuroophthalmology, neurologie, ophtalmologie, medicalcase, caseoftheday, emergency, medicalschool, residency, medicine, redeye, neurology, eye, doctor, neuroophtho, theeyeshaveit, neurología, sight, eyeexam, ccf, vision, oftalmologia, corkskewvessel, cavernoussinus, brain, ophthalmology, neurologia, oftalmología, eyeemergency

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