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. Author manuscript; available in PMC: 2010 Dec 6.
Published in final edited form as: Handb Clin Neurol. 2009;93:595–611. doi: 10.1016/S0072-9752(08)93029-3

Figure 14. Indirect dural carotid cavernous fistula with bilateral sixth nerve palsies.

Figure 14

(A) External photograph of a 55 year old woman with bilateral sixth nerve palsies with esotropia, and dilation of the episcleral vessels in both eyes. T2-axial brain MRI through the upper part of the orbits (B) and T1-coronal orbital MRI with contrast and fat suppression showing dilation of both superior ophthalmic veins (arrow heads). A catheter angiogram showed a complex indirect dural carotid cavernous fistula draining mostly posteriorly.