Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 8 , ISSUE 1 ( January-April, 2019 ) > List of Articles


Carotid Cavernous Fistula: An Easily Missed Complication of Blunt Traumatic Brain Injury

Saptarshi Biswas, Arpit Amin, Ashley Graziano, Shekhar Gogna

Keywords : Blunt trauma, Carotid cavernous fistula, Head injury

Citation Information : Biswas S, Amin A, Graziano A, Gogna S. Carotid Cavernous Fistula: An Easily Missed Complication of Blunt Traumatic Brain Injury. Panam J Trauma Crit Care Emerg Surg 2019; 8 (1):61-63.

DOI: 10.5005/jp-journals-10030-1238

License: CC BY-NC 4.0

Published Online: 01-12-2015

Copyright Statement:  Copyright © 2019; The Author(s).


A carotid cavernous fistula (CCF) is an abnormal vascular connection between the carotid arterial system and the cavernous sinus. Traumatic head injury, particularly basilar skull fractures, can result in a type A CCF. Type A CCFs are direct, high-flow shunts between the internal carotid artery and the cavernous sinus. Significant neuro-ophthalmologic sequela can result from such connections, including visual loss. These fistulas are commonly missed on the routine imaging completed following head trauma. If suspected, a cerebral angiography is the gold standard imaging modality, with endovascular coiling being the preferred treatment. Physicians should have a high index of suspicion for CCFs in trauma patients presenting with basilar skull fractures. Prompt recognition and treatment can resolve symptoms and prevent permanent sequela.

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