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Between 1984 and 1986, 7 patients with spontaneous carotid-cavernous fistulas (CCF) were treated by radiotherapy delivering 3,000 cGy (200 cGy, 5 times per week) to the sellar region. Improvements of clinical signs and symptoms were seen in all patients within 6 months of treatment. During a follow-up period of 7 to 35 months, 6 patients remained in good clinical condition and only one patient developed a recurrence. As an adverse effect, one patient developed early menopause, but no other side-effects or complications were seen. Radiotherapy should be considered in patients with spontaneous CCF, when CCF are seen in middle-high aged patients and progressive without relief of symptoms.
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