A 60-year-old woman presented with a cerebellar solid tumor manifesting as headache of 4 months, progressive vomiting, and ataxia of half a month. [ncbi.nlm.nih.gov]

Results: A 59-year-old woman presented with acute left-sided ophthalmoplegia. [scholars.northwestern.edu]

Clinical presentation is usually an acute onset of ocular symptoms and a pulsatile bruit is invariably present. [ajnr.org]

“Indirect” or “dural” carotid-cavernous fistulas typically present in elderly women with hypertension in a more subtle fashion. [medlink.com]

• Dyspnea

  The female patient, working as a farmer and doing heavy work in the fields, was completely asymptomatic and had no shortness of breath and no dyspnea during her work. [juniperpublishers.com]

  Symptoms may include dyspnea or hemoptysis or may be consistent with bronchitis. These symptoms are affected by the number of stenotic veins as well as the severity of the stenosis. [aetna.com]

• Vascular Disease

  Dural cavernous sinus fistulas (DCSFs) are benign vascular diseases consisting in an arteriovenous shunt at the cavernous sinus that if misdiagnosed can lead to potentially serious ophthalmologic complications. [books.google.com]

  Direct CCFs may result from: Trauma Rupture of a cavernous carotid aneurysm A tear in the wall of a weak cavernous internal carotid artery caused by congenital collagen vascular disease. [upmc.com]

  Etiology Direct CCF may result from trauma, rupture of a cavernous carotid aneurysms, or from a tear in the wall of a congenitally weak cavernous ICA secondary to collagen vascular disease. Indirect CCF are usually spontaneous and idiopathic. [neurosurgery.pitt.edu]

  Spontaneous fistulae usually result from a ruptured carotid aneurysm, in collagen vascular disease, atherosclerotic disease, hypertension, or at childbirth 3. 2. Flow: high or low flow 3. [sonoworld.com]

• Diplopia

  Cavernous sinus tumors Acute or slowly progressive ophthalmoplegia is the dominant presentation, with diplopia being the most common symptom. At times, painful diplopia is present. Usually the patient has a preceding history of cancer. [emedicine.medscape.com]

  Seven patients complained of horizontal diplopia, whereas two had vertical diplopia and one had oblique diplopia. The nature of the diplopia in the remaining nine patients was not specified. [jnnp.bmj.com]

  Also, we found a relation between the presence of fistulas and improvement of diplopia (βb=7.02; 95% CI, 1.71 to 12.32) and between increased age and improvement of diplopia (βb=3.68; 95% CI, 0.71 to 6.7). [stroke.ahajournals.org]

  Patients experiencing diplopia can be treated with prism or occlusion therapy and IOP-lowering medications can be started if IOP is substantially elevated. [eyewiki.org]

  Kim First published December 26, 2006, DOI: https://doi.org/10.1212/01.wnl.0000232727.26213.77 A 54-year-old man developed sudden left-sided headache and diplopia. [neurology.org]

• Painful Ophthalmoplegia

  […] field defects Primary intracranial tumors: Isolated or combined ophthalmoplegia and/or primary aberrant regeneration of the third cranial nerve Cavernous sinus aneurysms Isolated or combined ophthalmoplegia Painful ophthalmoplegia Decreased pain sensation [emedicine.medscape.com]

  Case Description: A 53-year-old woman suffered severe left painful ophthalmoplegia. A magnetic resonance image (MRI) revealed thickness of the left cavernous sinus (CS). [surgicalneurologyint.com]

  […] is associated with pain. [1] Differential diagnosis Myasthenia Gravis Thyroid associated orbitopathy Internuclear ophthalmoplegia Chronic progressive external ophthalmoplegia Orbital pseudotumor Giant cell arteritis Acquired oculomotor nerve palsy evaluation [eyewiki.aao.org]

  (A) Preoperative anteroposterior angiogram showing agiant aneurysm of the right intracavernous internal carotid artery (ICA) in a 76-year-old woman (Case 17) who presentedwith progressive ophthalmoplegia and orbital pain. [barrowneuro.org]

• Pulsating Exophthalmos

  Cavernous sinus lesions are characterized by the following signs: Unilateral and isolated third, fourth, or sixth cranial nerve palsy Variety of combination nerve palsies resulting in partial or complete ophthalmoplegia Painful ophthalmoplegia Proptosis (pulsating [emedicine.medscape.com]

• Unilateral Blindness

  Triad of unilateral blindness, orbital fractures and massive epistaxis’ after head injury. J. Neurosurg., 1961;18: 837. 5. Mahmoud, NA. Traumatic aneurysm of the internal carotid artery and epistaxis. (Review of literature and report of a case). J. [jpma.org.pk]

• Tinnitus

  Sigmoid sinus diverticulum and pulsatile tinnitus: analysis of CT scans from 15 cases. [connection.ebscohost.com]

  Swelling of the membranes that cover the outside of the eyes and line the eyelids Forward displacement of the eyeballs Deteriorating vision Cranial nerve palsies Nosebleed Headache Bruit (a blowing sound in the vessel that can be heard with a stethoscope) Tinnitus [upmc.com]

  Cranial nerve palsies, epitaxis, headache, bruit, and tinnitus may be present with either anterior or posterior drainage. Rare cases with subarachnoid hemorrhage. [neurosurgery.pitt.edu]

  Those fistulas that involve the transverse and sigmoid sinuses, 2 of the most common locations for DAVFs, frequently cause pulsatile tinnitus. [ingentaconnect.com]

  […] diplopia, dysarthria, dysphagia, positional vertigo); or To evaluate members with signs/symptoms highly suggestive of leaking/ruptured ICA or AVM (i.e., blood in the cerebral spinal fluid, stiff neck, sudden explosive headache); or To evaluate pulsatile tinnitus [aetna.com]

• Pulsatile Tinnitus

  Sigmoid sinus diverticulum and pulsatile tinnitus: analysis of CT scans from 15 cases. [connection.ebscohost.com]

  tinnitus or lower cranial nerve dysfunction due to dissection-related mass effect. [neuroangio.org]

  H93.A1 - H93.A9 Pulsatile tinnitus I60.00 - I60.9 Nontraumatic subarachnoid hemorrhage I67.0 - I67.9 Other cerebrovascular diseases I71.02 - I71.03 Dissection of abdominal or thoracoabdominal aorta I71.3 - I71.4 Abdominal aortic aneurysm, ruptured or [aetna.com]

  Those fistulas that involve the transverse and sigmoid sinuses, 2 of the most common locations for DAVFs, frequently cause pulsatile tinnitus. [ingentaconnect.com]

• Meningism

  A singular case of cavernous internal carotid artery aneurysm in patient with cavernous sinus syndrome and bacterial meningitis. [moh-it.pure.elsevier.com]

  Type B is a fistula between meningeal branches of the internal carotid artery and cavernous sinus. Type C is a fistula between meningeal branches of the external carotid artery and cavernous sinus. [medlink.com]

  Meninges The meninges cover the cavernous sinus. They are thicker laterally and superiorly than medially and inferiorly. The most common tumor to arise from the meninges is of course the meningioma. [radiologyassistant.nl]

  Anatomy: direct and indirect, according to the arterial branch involved (internal carotid artery [ICA], meningeal branches of the internal carotid artery or external carotid artery [ECA]). [sonoworld.com]

Differential diagnoses include orbital cellulitis, orbital apex syndrome, ICA aneurysm, malignancy of the CS, trauma, carotid-cavernous fistula (CCF), Tolosa-Hunt Syndrome, and ischemic stroke (6,14) Workup If CST is suspected, imaging should be ordered [emdocs.net]

Nevertheless, basic workup must be done. [eyewiki.aao.org]

The patient was admitted for further workup. A brain MRI demonstrated metastatic involvement of the cavernous sinus ( Figures 3, 4 ). [touchoncology.com]

Device (PED) has been described for the treatment of brain aneurysms. [scholars.northwestern.edu]

Endovascular treatment of a giant internal carotid artery bifurcation aneurysm with drainage into cavernous sinus Chin Med J, 2012,125(03) : 539-542. [cmj.yiigle.com]

Treatment Twenty one of the 31 patients (68%) underwent treatment of their CCAs (table 3). [jnnp.bmj.com]

Diplopia, if present before treatment, improved in nearly all patients after treatment by coiling and in 81% of patients after treatment by means of balloon occlusion. [stroke.ahajournals.org]

Endovascular treatment with coils is effective in occluding the fistula. [ncbi.nlm.nih.gov]

prognosis for dural CCF is very good. [eyewiki.org]

Brain aneurysm: A cavernous aneurysm is a common finding that if truly cavernous, indicates that it is located outside of the brain and generally carries a benign prognosis. [healthtap.com]

Long-term prognosis in patients with vasculopathic sixth nerve palsy. Am J Ophthalmol 2002; 134 : 81–84. 13. Patel SV, Homes JM, Hodge DO, Burke JP. Diabetes and hypertension in isolated sixth nerve palsy. Ophthalmol 2005; 112 : 760–763. [nature.com]

The long term prognosis for treated cases is relatively good, with most complications occurring immediately after the procedure. [jnnp.bmj.com]

CSS has a multitude of etiologies. [touchoncology.com]

The most common known etiology is a posterior communicating artery aneurysm. This is a medical emergency. [eyewiki.aao.org]

After sections on anatomy and classification, etiology and pathogenesis of DCSFs, the symptomatology of the disease is described in detail. The role of modern imaging techniques in the diagnosis of DCSFs is then addressed. [books.google.com]

The differential diagnosis of a cavernous sinus syndrome includes a wide array of vascular, infectious, inflammatory, and neoplastic etiologies. Fortunately, among vascular lesions, cavernous aneurysms are usually indolent and rarely rupture. [synchropublisher.com]

Etiology Direct CCF may result from trauma, rupture of a cavernous carotid aneurysms, or from a tear in the wall of a congenitally weak cavernous ICA secondary to collagen vascular disease. Indirect CCF are usually spontaneous and idiopathic. [neurosurgery.pitt.edu]

Cavernous carotid artery aneurysms: Epidemiology, natural history, diagnostic and treatment. An experience of a single institution. Clin Neurol Neurosurg 2014;125:32-5. [ PUBMED ] 4. [neurologyindia.com]

We briefly reviewed the literature of similar cases and tried to analyze the possible pathophysiological relationship between these findings. [moh-it.pure.elsevier.com]

Dural carotid cavernous fistula Pathophysiology Direct carotid cavernous fistula – Arise most commonly secondary to a traumatic tear of internal carotid artery within the cavernous sinus. [eyewiki.org]

In some cases, the precise site of the lesion is clear, whereas in others, the location of the lesion is speculative. [1] Pathophysiology To understand the pathophysiology of the oculomotor nerve palsy it is essential to know its track. [eyewiki.aao.org]

Pathophysiology The two cavernous sinuses are located on both sides of the sella turcica. [emdocs.net]

Discussion Several classifications of CCF exist depending on anatomy, aetiology, and pathophysiology. One categorisation divides between traumatic and spontaneous fistulas. [jnnp.bmj.com]

Page 344 - Primary prevention of ischemic stroke: A statement for healthcare professionals from the Stroke Council of the American Heart Association. ‎ [books.google.com]

To contain the infection, the body's immune system creates a clot to prevent bacteria or other pathogens from spreading. The clot increases pressure inside the brain. This pressure can damage the brain and may ultimately cause death. [webmd.com]

Although CCFs from ruptured cavernous sinus aneurysms may close spontaneously, as in 2 of our patients with low-flow CCFs, angiography and endovascular closure of the fistula should follow promptly to prevent possible hemorrhage from engorged cortical [ajnr.org]

The combination of coils and thrombus forms a plug which prevents blood from going into the aneurysm, and protects the aneurysm from rupture. Depending on the shape of the aneurysm, the coils may have a hard time staying inside. [med.nyu.edu]