Carotid-cavernous fistula syndrome

For a long time the striking clinical pic­ ture resulting from a carotid-cavernous fistula has been recognized as the manifesta­ tion of a communication between the carotid artery and the cavernous sinus. About 75 percent of the occurrences are attributable to known trauma, as was our case, and the remaining 25 percent appear to have a spontaneous origin secondary to a vascular lesion.' In Locke's cases of pulsating exophthalmos, 77 percent were traumatic in origin, and, of these, 94 percent had a carotid-cavernous fistula. Head injuries, gun­ shot wounds, and so forth, are responsible for the traumatic type;· sclerosis of the arterial wall with resultant weakness causes the spontaneous ones.