[A case of atypical course after balloon occlusion for high flow traumatic carotid-cavernous fistula]

We treated a patient with a high flow traumatic carotid-cavernous fistula (CCF) by transarterial balloon occlusion. A 26-year-old male sustained an injury of the head. After 2 months he was admitted to our hospital due to exophthalmos, congestion of the palpebral conjunctiva. Right common carotid angiography showed a CCF with high flow shunt. He was treated by the endovascular balloon technique. Following the operation, abducens nerve palsy, headache, vomiting and convulsion developed and disappeared gradually within one week. Post operative 123I-IMP-SPECT revealed hyperperfusion of cerebral circulation compared to preoperative one. Post operative rt-carotid angiography showed pseudoaneurysm at cavernous portion of internal carotid artery. We discussed on abducent nerve palsy, pseudoaneurysm and hyperperfusion syndrome.