Carotid cavernous fistula secondary to ruptured giant intracavernous aneurysm of the internal carotid artery is rare. We report a case of direct carotid cavernous fistula secondary to rupture of a giant intracavernous ICA aneurysm. The presence of mirror or twin aneurysms of bilateral ophthalmic arteries raises therapeutic challenge.
Coiling of the intracavernous aneurysm could partially occlude the fistula. Complete closure of the fistula was facilitated by secondary carotid compression.
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