Spontaneous subarachnoid hemorrhage as the primary manifestation of carotid cavernous fistulas: case report

Arq Neuropsiquiatr. 2001 Sep;59(3-A):593-5. doi: 10.1590/s0004-282x2001000400021.


We report the case of a 19-year old male patient initially admitted to our service after a motor vehicle accident with a normal neurologic evaluation and a CT scan that revealed no abnormalities. Nineteen months later, he was readmitted after a subtle headache episode, followed by a brief loss of consciousness. He was submitted to a complete evaluation, which revealed no abnormalities (even in the neurologic and ophthalmologic exams). A CT was performed revealing a diffuse subarachnoid hemorrhage. Contrast enhancement displayed a right paraselar lesion, which was first interpreted as a giant aneurysm. The patient underwent a cerebral angiography which showed a right carotid-cavernous fistula with retrograde venous drainage through the superior and inferior petrosal sinuses. Filling of various cortical vessels was observed. The patient was treated with endovascular technique and a control angiographic study assured the complete closure of the fistula. He had an excellent clinical recovery, being discharged in good conditions.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Carotid-Cavernous Sinus Fistula / complications*
  • Carotid-Cavernous Sinus Fistula / diagnostic imaging
  • Carotid-Cavernous Sinus Fistula / therapy
  • Humans
  • Male
  • Radiography
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / etiology*
  • Subarachnoid Hemorrhage / therapy