Bilateral carotid-cavernous fistulae of mixed types with unusual radiological and neuropathological findings

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Abstract
A case [human] of bilateral post-traumatic carotid-cavernous fistulae (CCF), of both typical and atypical types, with delayed clinical deterioration was described. Unusual neuropathological lesions, distinctive from those due to direct cerebral trauma, were related to combined arterial ischemia and venous hypertension. Atypical CCF was not necessarily a benign disorder. Radiological monitoring was essential to detect spontaneous progressive intracranial shunting, to predict areas that are at risk from venous hypertension, and to identify remote sites of circulatory vulnerability.