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Background <p>Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous shunts between the carotid arterial system and the cavernous sinus. They most frequently present with ocular symptoms, but intracerebral hemorrhage (ICH) as an initial manifestation is exceedingly rare.</p> Case presentation <p>We report the case of a 41-year-old male with a progressive hemiparesis and a spontaneous CCF with atypical reflux into the deep cerebral veins and subsequent intracerebral hemorrhage, discuss the underlying pathomechanism, and provide an overview of the existing literature.</p> Conclusion <p>CCFs should be included in the differential diagnosis of ICH, particularly when atypical venous drainage patterns are involved.</p>

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Intracerebral hemorrhage and carotid-cavernous fistulas: a rare connection

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月6日

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  • Christian Gronemann,
  • Sarah Panahabadi,
  • Julia Layer,
  • Felix J Bode,
  • Franziska Dorn

摘要

Background

Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous shunts between the carotid arterial system and the cavernous sinus. They most frequently present with ocular symptoms, but intracerebral hemorrhage (ICH) as an initial manifestation is exceedingly rare.

Case presentation

We report the case of a 41-year-old male with a progressive hemiparesis and a spontaneous CCF with atypical reflux into the deep cerebral veins and subsequent intracerebral hemorrhage, discuss the underlying pathomechanism, and provide an overview of the existing literature.

Conclusion

CCFs should be included in the differential diagnosis of ICH, particularly when atypical venous drainage patterns are involved.