1. HEAD AND NECK IMAGING
EHAB ABOU ELFOTOUH. MD.

2.  Orbital Varices.
 Increased antero-grade flow, can result from vascular
malformations of the face and scalp.
 Obstruction of distal venous drainage, as cavernous sinus
thrombosis.
 Ab-normal retro-grade flow, as carotid–cavernous fistula.
 Increased intracranial pressure.
 Normal variant.

3.  Most common cause of spontaneous orbital
hemorrhage.
 Lesions result from congenital weakness in
post-capillary venous wall.
 Have a large communication with the venous
system and distend during maneuvers that
increase venous pressure.

4.  Have only a small
communication with
the venous system
and do not distend.
 Patients with usually
manifest stress or
painful proptosis.

5.  CT images:
 Normal
appearance, axial on
supine position.
 Or mild enlargement of
the involved veins.
 Increases venous
pressure is required to
demonstrate lesion
distensibility.

6.  Varices may be
smooth club-like,
triangular, or
segmental dilatation
of Opth. veins.
 Orbital mass of
vessels.

9.  At MR imaging:
 Hypo- to hyper-
intense signal on T1.
 Hyper-intense signal
on T2.
 Intense enhancing
pattern.

11.  Fed by ophthalmic artery branches.
 Consist of multiple congenital micro-vascular
connections between arteries and veins.
 Manifest with peri-orbital swelling, dilated
retinal veins, visible or palpable pulsations, an
audible bruit, glaucoma, and, visual field
defects.

14.  Oculocerebro-cutaneous
syndrome.
 Consists of unilateral
AVM of the visual
pathways and midbrain.
 Facial vascular nevi or
telangiectasias.
 Patients present with
intracranial hemorrhage,
optic atrophy and
pulsatile exophthalmos.

16.  Abnormal communication between the
cavernous sinus and one or more branches of
the internal or external carotid artery.
 Causes direct trauma, surgery, dural sinus
thrombosis, or spontaneously.
 Spontaneous with Ehlers-Danlos syndrome
and osteogenesis imperfecta.

17.  Manifest with the
classic triad of pulsatile
exophthalmos,
conjunctival chemosis,
and an auscultatory
bruit.
 Gradual decrease in
visual acuity.
 Palsy of cranial nerves
III, IV, V, and VI.

18.  CT or MR imaging:
 Proptosis.
 Extraocular muscle
enlargement.
 Superior ophthalmic
vein distention.
 Cavernous sinus
dilatation .

26.  Intracanalicular ophthalmic artery aneurysms are
extremely rare.
 More common carotid-ophthalmic artery
aneurysms.
 Arise at origin of the ophthalmic artery.
 May extend intra-cranially above the sella and
sometimes extend into or through optic canal.
 Lesion withdiameter of 2–3 mm are usually
asymptomatic.
 More than 3 mm may compress the artery or optic
nerve or rupture.