Unilateral double carotid cavernous fistula treated with detachable balloons.

Direct fistulas between the internal carotid artery and the cavernous sinus are mostly posttraumatic and are due to laceration of the carotid siphon or rupture of its intracavernous branches (1]. The fistula is usually unilateral but can be bilateral [1 , 2]. In general , only one communication occurs betwe~n the carotid siphon and the cavernous sinus, as was shown in a large number of cases when the defect in the vessel wall was closed via balloon embolization (3-5] . We report a case of posttraumatic carotid cavernous fistula in which two defects were present in the carotid siphon .