Diagnosis and follow-up of carotid-cavernous fistulas by carotid duplex sonography and transcranial color Doppler imaging

Yu Wei Chen, Jiann Shing Jeng, Hon Man Liu, Ping Keung Yip, Bao Show Hwang, Win Hwan Lin, Yang Chyan Chang, Yong Kwang Tu

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To investigate the suitability of extracranial carotid duplex (ECD) and transcranial color Doppler imaging (TCDI) in the diagnosis and follow-up of treatment in patients with carotid-cavernous fistulas (CCF), combined ECD and TCDI examinations were studied in seven patients with traumatic CCF. According to angiography, four patients had direct CCF, two indirect CCF and one both direct and indirect CCF. In ECD, hemodynamic parameters of the feeding artery showed an abnormally increased flow volume and decreased resistivity indices in five direct CCFs from the internal carotid artery and one indirect CCF from the external carotid artery. Direct visualization of the CCF was achieved in patients with direct CCF only, and revealed itself as a heterogeneous mosaic flash resulting from high flow velocities and turbulence. Patterns of venous drainage were detected via the transorbital and transforaminal windows in seven and five patients (four direct and one indirect CCF patients), respectively. These abnormal findings were improved or even normalized after successful treatment. In conclusion, combined ECD and TCDI examinations appear to be useful for the diagnosis and follow-up of CCF.

Original languageEnglish
Pages (from-to)1155-1162
Number of pages8
JournalUltrasound in Medicine and Biology
Issue number9
Publication statusPublished - Dec 1 1996
Externally publishedYes



  • Arteriovenous fistula
  • Carotid-cavernous sinus
  • Doppler
  • Duplex
  • Transcranial
  • Ultrasonography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Biophysics
  • Acoustics and Ultrasonics

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