Spontaneous bilateral carotid-cavernous fistulas secondary to cavernous sinus thrombosis

Fawaz Al-Mufti, Krishna Amuluru, Mohammad El-Ghanem, Abhinav R. Changa, Inder Paul Singh, Chirag D. Gandhi, Charles J. Prestigiacomo

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations


Bilateral carotid cavernous fistulas are rare entities that can cause debilitating symptoms and can lead to more severe consequences if left untreated. Therefore, the recognition and adequate treatment of these pathologies is very important. We present 2 cases of bilateral carotid cavernous fistulas that arose as a result of cavernous sinus thrombosis. We review the literature and discuss the pathophysiology, symptomatology, management, and treatment of bilateral carotid cavernous fistulas. Within our own cases, treatment of the patients was varied. The patient in case 1 was successfully treated with endovascular therapy after a failed trial of anticoagulation. The patient in case 2 demonstrated resolution of bilateral carotid cavernous fistulas after anticoagulation therapy. Case 2 highlights the fact that certain cases of bilateral carotid cavernous fistulas due to cavernous sinus thrombosis may benefit from extensive anticoagulation therapy. If anticoagulation therapy is unsuccessful, endovascular therapy may prove beneficial in resolving the fistulous shunt.

Original languageEnglish (US)
Pages (from-to)646-654
Number of pages9
JournalClinical neurosurgery
Issue number4
StatePublished - Apr 1 2017

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology


  • Anticoagulation
  • Carotid-cavernous fistulas
  • Cavernous sinus thrombosis
  • Dural fistula
  • Endovascular therapy
  • Neuroradiology
  • Otitis media


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