67-year-old male with vertigo and left-sided fullness. Evaluate for mass. Asymmetric fullness of the left cavernous sinus and left intracranial internal carotid and middle cerebral arteries raises the question of left cavernous-carotid fistula. MRI/MRA could be performed to help exclude this possibility.There is no evidence of intracranial hemorrhage, mass or edema. The ventricles and basal cisterns are normal in size and configuration.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Asymmetric fullness of the left cavernous sinus and proximal internal carotid and middle cerebral arteries and raises the question of cavernous carotid fistula. MRI/MRA could be obtained to further evaluate as clinically indicated.