Question

Classify carotico-cavernous fistulae based upon the angioarchitecture.

Hint:

Direct CCFs are high-flow, while indirect CCFs are low-flow. The classification is important for determining treatment options.

Answer 1

Carotico-cavernous fistulae (CCF) can be classified based on their angioarchitecture into two main categories: direct and indirect.
Step 1: Direct Carotico-Cavernous Fistulae:
These are high-flow fistulae that occur when there is a direct communication between the cavernous sinus and a branch of the carotid artery. This type is typically caused by trauma. Angiographic findings show a direct connection between the artery and the cavernous sinus.

Step 2: Indirect Carotico-Cavernous Fistulae:
These are low-flow fistulae where there is no direct connection between the artery and the cavernous sinus. Instead, blood flows through an abnormal network of vessels. Indirect CCFs are often congenital or arise from other vascular abnormalities.