BACKGROUND: Carotid cavernous fistulas are cerebral artenovenous shunts which may present with ocular or orbital signs. Direct fistulas are distinguished from dural shunts with respect to the anatomical situation. PATIENTS: We report on two patients with spontaneous dural carotid cavernous fistulas with multiple feeding vessels. Both patients required endovascular embolization. RESULTS: Therapy was successful in both patients. We present an overview of the clinical picture, the diagnostic procedure, the differential diagnosis and the therapeutic possibilities in this clinical entity. CONCLUSION: Both patients prove the importance of an immediate differential diagnostical classification so that a specific neuroradiological diagnostic can be ensured. Today's advanced endovascular technology offers therapeutic options with less risk for the patient than in recent years.
BACKGROUND: Carotid cavernous fistulas are cerebral artenovenous shunts which may present with ocular or orbital signs. Direct fistulas are distinguished from dural shunts with respect to the anatomical situation. PATIENTS: We report on two patients with spontaneous dural carotid cavernous fistulas with multiple feeding vessels. Both patients required endovascular embolization. RESULTS: Therapy was successful in both patients. We present an overview of the clinical picture, the diagnostic procedure, the differential diagnosis and the therapeutic possibilities in this clinical entity. CONCLUSION: Both patients prove the importance of an immediate differential diagnostical classification so that a specific neuroradiological diagnostic can be ensured. Today's advanced endovascular technology offers therapeutic options with less risk for the patient than in recent years.