clinical features

Last reviewed 01/2018

The clinical features of a carotid cavernous fistula are usually unilateral but bilateral signs may develop as a result of communication with the contralateral venous sinus.

Characteristically, there is:

• sudden onset of pain
• prominent facial veins
• III, IV and VI nerve palsies
• papilloedema, retinal haemorrhage, optic atrophy and consequent visual impairment
• exophthalmos - may be pulsatile
• cranial bruit heard best over the eyeball