Carotid cavernous fistulas and Doppler flow velocity measurements

In 44 patients a Doppler ultrasound investigation was performed. Fourteen patients had a traumatic carotid-cavernous fistula (CCF), 21 a spontaneous CCF, four an orbital-cerebral-facial arteriovenous malformation and five had venous disorders of the orbit. The study showed that this investigation can be an important diagnostic tool for CCF. The examination with the direction-sensitive Parks 806 and Versatone Medsonic Doppler and a 9.5 respectively 10 MHz transducer demonstrated specific Doppler patterns in 100% of the direct carotid-cavernous communications and in 80% of the dural orbital communications. The direct CCFs mainly showed abnormal patterns of common carotid artery and orbital vein, while the dural or purely orbital CCFs especially showed abnormalities of the orbital patterns. Progression or improvement of the haemodynamic disturbances could also be proved by this method.