In this paper, eight cases of spontaneous carotid-cavernous fistula (CCF) are presented and their treatment is discussed.
Three were treated with electrothrombosis by copper needle insertion, three were treated with irradiation and two were observed conservatively.
Angiographic examination showed that the CCF disappeared completely in all three patients who underwent electrothrombosis, but in two cases clinical complications appeared; i. e., transient oculomotor palsy and Gerstmann's syndrome due to stenosis of the internal carotid artery.
Lineac irradiation was applied to the fistula (100 rad per day, three times per week, total dose 4000 rad).
Clinical symptoms of all three patients improved, and angiographic examination showed that the fistulas were reduced in size in two cases and disappeared in the other.
Angiographically, spontaneous CCF were divided into three groups: localized, scattered and mixed type.
The scattered type was easily curable with any treatment, which is assumed to be because of the low blood flow at the fistula in this type.
Irradiation of spontaneous CCF is thought to be feasible as a first-choice treatment because it is non-invasive and effective.
