Srinivasan A, et al. - An appraisal was performed of the diagnostic sensitivity and specificity of orbital color Doppler imaging (CDI) and conventional neuroimaging (CT/MRI) compared with cerebral angiography, in patients with carotid-cavernous fistulas (CCFs). It was determined that the color Doppler imaging was a beneficial noninvasive, radiation-free modality for the diagnosis of CCF with anterior drainage. It exhibited higher sensitivity than CT or MRI, but equivalent specificity. The paucity of the usefulness in diagnosing fistulas with posterior cortical venous drainage, which carried a risk of intracerebral hemorrhage and stroke served as a prominent limitation of CDI. 10% of unilateral CCFs with anterior orbital signs and symptoms illustrated angiographic evidence of posterior cortical venous drainage.