Neuroradiology (2017) 59:835–837 DOI 10.1007/s00234-017-1885-0 LETTER TO THE EDITOR The non-invasive search for the carotid-cavernous fistula: the added value of the 4D-CTA 1 1 2 Martinus J. van Amerongen & Sjoert A. H. Pegge & Mustapha El Kandoussi & 3 1 Hieronymus D. Boogaarts & Frederick J. A. Meijer Received: 7 July 2017 /Accepted: 11 July 2017 /Published online: 25 July 2017 Springer-Verlag GmbH Germany 2017 Dear Editor-in-Chief, performed. There were no signs of infection in the clinical Caroticocavernous arteriovenous fistula (CCF) is a well- presentation or subsequent serologic analysis. known, often acquired, vascular malformation with an abrupt Initial differential diagnosis consisted of CCF and orbital clinical presentation which can progress rapidly, possibly en- pseudotumor. Graves ophtalmopathy or infection was also dangering the visual acuity of the patient. Adequate diagnostic considered, however was deemed less likely. imaging is crucial for early diagnosis and treatment planning Orbital MRI including MRA was performed, which dem- in CCF. onstrated contrast-enhanced swelling of the intra- and peri- The optimal imaging strategy can be debated for evaluating orbital tissues with surrounding fat infiltration (Fig. 1a). this vascular malformation. In the following case, both MR There were no signs of a CCF on the time-of-flight
Neuroradiology 0028-3940 – Springer Journals
Published: Jul 25, 2017
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