Direct carotid-cavernous fistulas are a rare complication of craniofacial trauma that often presents with proptosis, chemosis, and other visual symptoms. Disruption of blood flow from a carotid-cavernous fistula can cause cortical and cranial nerve ischemia which requires emergent intervention. Upon clinical suspicion of a carotid-cavernous fistula, patients should undergo computed tomography angiography (CTA) or magnetic resonance angiography (MRA), and digital subtraction angiography (DSA) if no other etiology is suspected. We present a case of a middle-aged patient with a gunshot wound in the posterior pharynx that resulted in a direct carotid-cavernous fistula of the left internal carotid artery.
Keywords: Carotid-cavernous fistula; Craniofacial trauma; Endovascular coiling; Neurovascular angiography.
© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.