A 30-year-old woman with pulsating exophthalmia due to posttraumatic carotid-cavernous fistula underwent embolization with a detachable balloon. Because of balloon dislodgement, the drainage was derived to the superior ophthalmic vein and clinical worsening occurred. Complete ophthalmoplegia developed and visual acuity decreased. After a second embolization we inserted two balloons but the same findings were exaggerated. Finally coiling of the internal carotid artery was done and orbital decompression achieved. Ophthalmoplegia, proptosis, chemosis and nerve paralysis intraocular pressure improved.
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