Some authors stated that the aberrant ophthalmic vein
travels in this canal .
Risk factors for superior ophthalmic vein
thrombosis (SOVT) are multifactorial and include sinoorbital infections, autoimmune disorders (such as systemic lupus erythematosus, sarcoidosis, Behcet's syndrome, and Grave's disease), hypercoagulable states (such as pregnancy, use of oral contraceptive pills, sickle cell trait, and hereditary hemorrhagic telangiectasia), and systemic malignancies.
It was found that superior ophthalmic vein
(SOV) blood flow was lower in active GO .
The choroidal veins drain in the ophthalmic veins
and are devoid of the valve; therefore, systemic conditions that affect blood flow in the ophthalmic veins
may influence the choroidal thickening .
This reversal directs a high amount of blood flow to the ophthalmic vein
and rarely leads to the cortical venous reflux and the congestion of cortical blood vessels .
On CT scan of the brain features of CCF like extraocular muscle thickness, dilated superior ophthalmic vein
and prominent cavernous sinus should be looked for.
For the diagnostic evaluation, CT and MRI studies help to detect proptosis, increased extraocular muscle size and a dilated or thrombosed superior ophthalmic vein
.3 Especially as an initial neuroimaging study MR angiography is preferred.4 In our case the patient was also diagnosed with the help of MRI and MR angiography which showed dilated superior ophthalmic vein
and the CCF (Figure-1).
CT and MR angiography reveals enlarged right cavernous sinuses with several dilated venous channels including ipsilateral superior ophthalmic vein
in the right orbit.
Additional features can be collapsed superior ophthalmic vein
, reduction in the angle of vein of Galen and internal cerebral vein (the venous hinge sign).29
Embolization of dural cavernous fistulas via superior ophthalmic vein
For example, the superior ophthalmic vein
connects with the angular, supraorbital, and supratrochlear veins, and it crosses over the optic nerve through the superior orbital fissure and drains into the cavernous sinus.
Orbital Venography is a very easy radiological procedure without any serious complication and gives the information regarding site of tumor, its vascularity and relationship with eyeball and other intra-orbital structures2.Displacement of the superior ophthalmic vein
in any direction from its normal course should be considered as abnormal.
If this failed, venous access was made and the cavernous sinus was cannulated with microcatheter from either the inferior petrosal sinus route or through angular / ophthalmic vein
and embolization was done by using pushable platinum coils (Figure-2) and/or cyanoacrylate glue.
Orbital venography often disclosed abnormalities in filling of the superior ophthalmic vein
or cavernous sinus, but these techniques are difficult and therefore not consistently performed.
J to an interventional neuroradiologist for evaluation of a suspected CCSE 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 veins
, and direct communication between the left ICA and dilated cavernous sinus.