Use of Color Doppler of Carotids in the Diagnosis of a Patient with Direct Carotid-Cavernous Fistula

Abstract

An 18-year-old patient developed a direct carotid fistula after a mild craniocerebral trauma. The patient presented with tinnitus and exophthalmia, both pulsatile and on the left. A carotid Doppler study revealed high blood flow velocities and reduced resistance rates in the left internal and common carotid arteries compatible with a direct carotid fistula. Computed tomography angiography of the brain confirmed the carotid fistula. The patient was successfully referred for endovascular embolization treatment. This case demonstrates that carotid Doppler may play an important role in the diagnosis of direct carotid fistulae and the follow-up of patients undergoing endovascular therapy.