Superior and inferior ophthalmic veins, (SOV, IOV) drain into CS which in turn drain into the superior and inferior petrosal sinuses
During the procedure, cerebral angiography demonstrated an 80% stenosis of the left ICA and an ipsilateral direct CCF draining into the contralateral cavernous sinus via the intercavernous sinuses, posteriorly into the internal jugular veins through the inferior petrosal sinuses (Fig.
c and d Left ICA angiography showing the high-grade stenosis (white arrow) and a direct carotid-cavernous fistula (CCF) that drained into contralateral cavernous sinus via the intercavernous sinuses, and posteriorly into the internal jugular veins through the inferior petrosal sinuses.
After the correct placement of the catheters, simultaneous blood samples are obtained from the periphery, left and right inferior petrosal sinuses
, and CRH or DDAVP is injected, and post-injection ACTH samples are obtained from each of the two sinuses and periphery at 3, 5, 10 and 15 minutes (3,14).