Bilateral Carotid-cavernous Fistulas Treated with Partial Embolization and Radiosurgery

Bilateral carotid-cavernous fistulas (CCFs) are rare. In this paper, we report the case of an 88-year-old woman who presented with a two-month history of worsening visual symptoms and was subsequently found to have bilateral Barrow grade D CCFs. Cannulation and complete embolization of the offending vessels during angiography proved unsuccessful, and so the patient underwent adjuvant radiosurgery as salvage therapy with a good clinical outcome. This case adds to the limited but growing literature on the multi-modal management of CCFs.