A carotid-cavernous sinus fistula (CCF) is a clinical condition when there is an abnormal
communication between the internal carotid artery, external carotid artery (ECA),
or any of their branches to the cavernous sinus. Traumatic CCF (TCCF) is the most
common type of all CCFs. This study aims to find clinical improvement of traumatic
carotid-cavernous fistulas (TCCF) after endovascular treatment. We predict the degree
of clinical recovery in an attempt to make the treatment of TCCF safe and effective.
This study reported a series of 28 patients with TCCFs undergoing coiling and ballooning
in a period of 3 years, i.e., from December 2014 to December 2017. This is a novel
case report about CCF in our country, Indonesia, especially in Surabaya. We performed
clinical, angiographical, and radiological assessments before and at regular time
periods after the procedure until 6 months. All patients had a partial and complete
occlusion of the fistula. Angiographic occlusion of fistula, visualization of the
ophthalmic artery, and disappearance of bruit predicted a good clinical outcome. All
patients made a recovery at different times, depending on the degree of fistulas and
treatment. Improvement in clinical symptoms had a direct correlation with the degree
of occlusion. Treatment was divided into coiling and ballooning depending on patient's
condition and angiographic examination. Trans femoral cerebral angiography is still
very important diagnostic tool in the diagnosis and treatment of TCCFs.
Key-words:
Cavernous sinus - endovascular embolization - traumatic carotid-cavernous fistulas
- trans femoral cerebral angiography