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Caroticocavernous fistula (indirect)

Case contributed by Frank Gaillard
Diagnosis certain

CT through the orbits demonstrates marked enlargement of the right superior ophthalmic vein associated with proptosis, straightening of the optic nerve and prominence of the right cavernous sinus. 

Angiography demonstrates both ICA and ECA shunting to the cavernous sinus and superior ophthalmic vein consistent with an indirect caroticocavernous fistula.

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