A 57-year-old woman attended the emergency department complaining of protrusion of the right eyeball for three days. The history revealed that she had head injury in a road traffic accident about five weeks ago. The accident had caused a fracture of the right angle of the mandible that was fixed internally by the maxillo-facial surgeon. Subsequent angiogram showed a right direct carotid-cavernous fistula. Endovascular therapy was successful in obliterating the fistula. She recovered well. Although carotid-cavernous fistula is an uncommon complication of head injury, emergency physicians should be aware of this condition because of its potential mortality and morbidity.
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ChumanH., TrobeJ.D., PettyE.M., SchwarzeU., PepinM., ByersP.H.Spontaneous direct carotid-cavernous fistula in Ehlers-Danlos syndrome type IV: two case reports and a review of the literature.J Neuroophthalmol2002; 22(2): 75–81.
