Original Article: PDF OnlyMonsein Lee H.; Rigamonti, DanieleNeurosurgery Quarterly: December 1996 - p 251-266 Buy Abstract Summary: Extrapial, carotid-cavernous, direct arteriovenous shunts or direct carotid-cavernous fistulas, as they are commonly referred to, are usually due to head trauma. Patients usually present with ophthalmologic symptoms but can suffer a host of neuroradiological problems. Modern minimally invasive techniques have been developed for the successul treatment of most of these patients. © Williams & Wilkins 1996. All Rights Reserved.