Venography of the orbit: pathology

Common variations of the lateral and occipital sinuses at the confluens sinuum

A total of 192 retrograde jugular venographies were performed in 163 cases. The lateral and occipital sinus variations in the confluent sinuum were classified in five groups by Kalbag [21]. Additional variations of the lateral and occipital sinuses in the confluent sinuum were discovered in this study.

Orbitography with a new non-ionizing water-soluble contrast medium

Metrizamide is a non-ionic water-soluble contrast medium which is isotonic with human blood and tissue fluid at a concentration of 170 mgI/ml. Retrobulbar injection of 3 ml isotonic metrizamide in the muscular conus of rabbits causes slight and inconstant cellulitis, but a similar reaction can also be found after injection of the same amount of saline. It seems probable that the introduction of fluid sufficient to cause an increase in the retrobulbar pressure can cause inflammatory changes in the orbital tissue, and that this is not always caused by the contrast medium itself. Four patients were examined by orbitography with injection of 4 ml isotonic metrizamide. There were no side effects, and the orbitograms showed contrast of good quality. Metrizamide is therefore considered very suitable for orbitography, especially in hospitals where computer-tomography is not yet available.

Spontaneous carotid-cavernous fistulas: phlebographic appearance and relation to thrombosis

Six consecutive cases with spontaneous carotid-cavernous fistulas were examined with orbital phlebography and bilateral carotid angiography. One of the fistulas was fed only by one internal carotid artery, 1 only by the accessory meningeal branch of the maxillary artery, while 4 were supplied by external as well as internal carotid arteries. The findings at phlebography seem to be characteristic. Thrombosis was demonstrated in all 6 cases. Different mechanisms for the genesis of thrombosis in association with carotid-cavernous fistulas are proposed. Alternative therapy methods are discussed.