Traumatic Carotid Cavernous Fistula Caused by Intradural Aneurysm Rupture: A Case Report

ogy requiring endovascular treatment. Most direct CCFs are secondary to traumatic injury involving the cavernous segment of the internal carotid artery (ICA). Rupture of an intracranial aneurysm (esp. intracavernous aneurysm) leads to CCF, epistaxis, or subarachnoid hemorrhage. On the contrary, TCAs comprise less than 1% of all intracranial aneurysms and are usually associated with penetrating head injuries or contiguous skull fractures. TCAs are primarily located in the peripheral cerebral vasculature or in the skull base. The circle of Willis is a relatively uncommon location for TCAs. In a separate lesion, a patient with CCF usually presents with Dandy’s triad of pulsatile exophthalmos, chemosis, and bruit. In contrast, a TCA is frequently asymptomatic until its fatal rupture (1). Trauamtic CCF caused by an intradural TCA rupture is an extremely rare condition. Surgical treatments such as trapping and sacrifice of the parent artery or direct surgical ligation of the aneurismal neck are often not possible because of their potential risks. We report a case of a traumatic CCF caused by rupture of the suprclinoid ICA aneurysm that was successfully treated by using detachable coils.