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Journal of Ultrasound in Medicine, Vol 13, Issue 7 557-564, Copyright © 1994 by American Institute of Ultrasound in Medicine
Carotid duplex and transcranial color-coded sonography in evaluation of carotid-cavernous sinus fistulas
S. K. Lin, S. J. Ryu and N. S. Chu
Department of Neurology, Chang Gung Memorial Hospital, 199 Tung-Hwa North Road, Taipei, Taiwan.
We performed carotid duplex and transcranial color-coded sonography in
three patients with traumatic and one patient with spontaneous
carotid-cavernous fistulas. High flow and low resistance were detected by
carotid Doppler imaging in the extracranial internal carotid artery in
three cases and in the external carotid artery in one case. The fistula
could be demonstrated directly as heterogenous color flashes with turbulent
flow by transcranial color-coded sonography through the orbital or temporal
window. The transorbital approach showed that the ophthalmic venous flow
was normal or to-and-fro bidirectional in patients without proptosis and
was retrograde, away from the cavernous sinus with arteriolization in
patients with proptosis. Combination of carotid duplex and transcranial
color-coded sonography provides a noninvasive method for more accurate
hemodynamic study of cerebral circulation and direct imaging of CCF.
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