[Low flow cavernous sinus fistula. Treatment by highly selective embolization].

Carotid-cavernous sinus fistulae are anomalous communications between the carotid artery and the cavernous sinus. They are classified according to whether they are traumatic or spontaneous, but distinction in relation to the anatomical origin of the branches of the carotid artery which supplies them is more important. The anatomy of the regional vasculature is analysed in this article. The vessels most frequently involved in spontaneous dural fistulae are the internal maxillary artery (from the external carotid) and the meningohypophyseal trunk (from the internal carotid) which anastomose respectively with the inferior cavernous sinus artery and with the ascending pharyngeal artery. We present two cases of spontaneous carotid-cavernous fistulae. Both were type D of Barrow's classification, and in view of progressive changes in the visual fields, it was decided to proceed with invasive treatment by highly selective embolization of the branches of the external carotid artery, which is currently the treatment of choice in such cases. Good results were obtained.