A carotid-cavernous fistula is an abnormal communication between the carotid artery and the veins of the cavernous sinus, creating a high-pressure, high-flow system. There is often a history of trauma. Patients may present with an audible bruit and progressive pulsatile proptosis with chemosis, restricted eye movement, and progressive visual loss in late stages (see TabM...^-^ ). The diagnosis is made by cerebral angiography, but a CT scan with contrast, MRI, or magnetic resonance angiography (MRA) may show the lesion (see T§ble.n.212n-3 and Chapter.23 ).
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