Carotid-cavernous sinus fistulae are rare ... Elevated pressure in veins draining the orbit can produce pulsatile tinnitus and ophthalmic signs and symptoms that include proptosis, chemosis ...

A cerebral angiogram performed the next week revealed a high-flow left internal carotid artery (ICA) cavernous fistula with marked cortical venous drainage, retrograde flow to the left ophthalmic ...