Carotid artery syndrome (cavernous sinus fistula syndrome; red-eyed shunt syndrome) 201

General: Seventy-five percent of cases caused by trauma; others occur spontaneously or are congenital; 414h75e fistula from carotid artery to cavernous sinus.

Ocular: Progressive, pulsating exophthalmos; distended pulsating superior orbital vein; venous congestion of lids; variable ophthalmoplegia, depending on involvement of cranial nerves III to VI; secondary glaucoma; congestion of conjunctiva with chemosis; corneal ulcerations; eversion of the lower lid; loss of corneal sensation; retinal edema; engorgement of retinal veins; papilledema; optic atrophy; ocular bruit that may be subjective and/or objective; diplopia; visual decrease; choroidal folds; dilated superior ophthalmic vein.

Clinical: Severe unilateral headache; buzzing noise.

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Flaharty PM, et al. Color Doppler imaging. A new noninvasive technique to diagnose and monitor carotid cavernous sinus fistulas. Arch Ophthalmol 1991; 109:522-526.

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