Supasai et al reported a clinical score for evaluating a patient with a carotid cavernous sinus fistula. A direct fistula is more urgent to repair than a dural type. The authors are from Khon Kaen University in Thailand.
Patient selection: carotid cavernous sinus fistula
Parameters:
(1) age in years
(2) trauma
(3) orbital bruit
(4) underlying diseases
(5) logMAR as a measure of visual acuity
Parameter
Finding
Points
age in years
< 45 years
5
45 to 55
2
> 55 years
0
trauma
no
0
yes
4
orbital bruit
no
0
yes
2.5
underlying disease
no
2
yes
0
logMAR
< 0.5
0
0.5 to 1.0
0.5
> 1.0
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 16.5
Total Score
Risk Category
Dural
Direct
< 5
low
26
1 (4%)
5 to 10
moderate
6
3 (33%)
> 10
high
0
24 (100%)
Performance:
• The authors claim an area under the ROC curve of 0.98.
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