57 yo M presenting with 2-3 weeks of L eye redness, and found to have increased intraocular pressure
1. Left-sided carotid-cavernous fistula, likely indirect. Enlarged left superior ophthalmic vein. Enlarged left accessory meningeal artery and a branch of the ascending pharyngeal artery (jugular division of the neuromeningeal trunk).
2. Additional ASL signal in the left transverse sinus and multiple prominent vessels within the left posterior fossa coursing from left transverse and sigmoid sinuses related to above cavernous sinus venous reflux into the petrosal sinus.
(Indirect carotid-cavernous fistula)