A 44-year-old woman presented with a painful abducens nerve palsy in the left eye. Examination revealed a white, quiet eye and an orbital bruit without proptosis. Magnetic resonance imaging demonstrated abnormal ipsilateral dural-based enhancement. Angiography confirmed a posterior draining carotid-cavernous fistula. Symptoms resolved spontaneously in approximately 8 months. The classification and treatment options for carotid-cavernous fistula are discussed.
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