A 37-year-old man with a history of head trauma surgery 8 years previously was admitted because of persistent pulsatile exophthalmos and intracranial murmur. Angiography results showed that blood from the right internal carotid artery flowed directly into the cavernous sinus , with the arterial system above the cavernous sinus not visualized
early visualization of the right venous sinus system
dilation of the right superior ophthalmic vein and the medial canthal vein. Bilateral anterior and middle cerebral arteries were perfused through the left internal carotid artery. We diagnosed a right-sided carotid-cavernous fistula. After a comprehensive preoperative assessment, we chose spring coil embolization treatment, which resulted in the disappearance of symptoms after treatment. Three months later, on follow-up, the patient reported no longer hearing intracranial murmur, and auscultation of the right temporal region showed no abnormal sounds.