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Related Experiment Videos

Long delayed traumatic carotid-cavernous sinus fistula.

Trang Nguyen1, Young Hoo Cho, Yu Jin Jang

  • 1Department of Reconstructive and Maxillofacial Surgery, Vietnam-Cuba Hospital, Hanoi, Vietnam.

The Journal of Craniofacial Surgery
|May 30, 2013
PubMed
Summary

Traumatic carotid-cavernous sinus fistula (TCCF) can manifest weeks after head injury. This case highlights a delayed TCCF presentation 8 weeks post-trauma, emphasizing extended follow-up for skull base fractures.

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Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Trauma Surgery

Background:

  • Traumatic carotid-cavernous sinus fistula (TCCF) is a rare vascular complication following craniomaxillofacial trauma.
  • While often presenting early, TCCF symptoms can be delayed by several weeks post-injury.

Observation:

  • A patient with a blunt head injury and skull base fracture developed delayed TCCF symptoms 8 weeks postoperatively.
  • Symptoms included tinnitus, orbital bruit, diplopia, eye pain, headache, and limited ocular movement.
  • Brain angio-CT confirmed the fistula and associated superior ophthalmic vein dilation.

Findings:

  • Endovascular coiling successfully occluded the carotid-cavernous sinus fistula.
  • Immediate symptom relief from tinnitus, bruit, and headache was observed post-procedure.

Related Experiment Videos

  • Significant improvement in cranial nerve VI palsy and related symptoms occurred within 4 months.

    • Implications:

    • This case demonstrates a delayed TCCF presentation occurring 8 weeks post-trauma, longer than previously reported.
    • Recommends a 2-month follow-up period for patients with skull base fractures to detect delayed TCCF.
    • Highlights the importance of vigilant monitoring for delayed vascular complications after head trauma.