Caroticocavernous Fistula Workup
- Author: Michael G Nosko, MD, PhD; Chief Editor: Brian H Kopell, MD more...
Lab studies include the following:
- Routine preangiography workup to evaluate coagulation and renal function prior to delivering contrast dye includes the following:
- CBC count
- PT and PTT
Imaging studies include the following:
- Selective carotid angiography
- Diagnostic test of choice
- Helps confirm diagnosis
- Helps determine type classification
- Provides therapeutic capability
- An angiogram is depicted in the image below.
- CT scan of orbit
- Contrast CT scan of the orbit - Helps establish diagnosis
- May demonstrate proptosis, swelling of extraocular muscles, and dilation of superior ophthalmic vein
- Orbital ultrasound - Demonstrates same findings as CT scan
- In a study of time-resolved magnetic resonance angiography (MRA) in 6 patients with carotid-cavernous fistulas, typical morphological findings (including enlargement of the superior ophthalmic vein, exophthalmos) were found in all cases. According to the authors, time-resolved MRA may provide relevant hemodynamic information to help plan interventional treatment.
Complete ophthalmologic workup includes the following:
- Visual acuity
- Pupillary function
- Intraocular pressure
- Funduscopy (direct and indirect)
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