Spontane Carotis-cavernosus-Fistel bei Morbus Osler-Rendu - Teleangiektasia hereditaria

A 37-year-old woman suffered from headaches, right facial pain, double vision and occasional tinnitus. On examination there was only a slightly dilatated right pupil, weakened corneal reflex and capillary bleeding from telangiectasia of both hands. Similar bleedings occured in her mother (mouth and hands) and son (nose). The arteriography of the right carotid artery showed a cavernous sinus fistula with a small shunt. Steady compression of the carotid artery by hand caused a marked improvement in the subjective symptomatology.