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Year : 2020  |  Volume : 25  |  Issue : 1  |  Page : 53-56

Incidental traumatic carotid cavernous fistula discovered only on conventional cerebral angiography: A case report

1 Department of Radiology, University of Benin, Benin City, Nigeria
2 Department of Radiology, Taoyuan General Hospital, Taoyuan City, Taiwan

Correspondence Address:
Dr. Festus O Ehigiamusoe
Department of Radiology, University of Benin, PMB 1154, Benin City, Edo State.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijmh.IJMH_28_19

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Carotid cavernous fistula (CCF) is not an uncommon occurrence in patients involved in road traffic accident with head injury. It involves an abnormal communication between the cavernous sinus and the carotid arteries presenting with clinical features. Its pathogenesis could be traumatic or spontaneous. Our patient was a 32-year-old woman involved in a road traffic accident with head injury. Emergency cranial computed tomography scan revealed subarachnoid hemorrhage and suspected aneurysm of the left internal carotid artery. Subsequent computed tomographic angiography and magnetic resonance angiography were negative for aneurysm or CCF, but a latter digital subtraction cerebral angiography showed florid signs of CCF (dilated cavernous sinus and left ophthalmic vein), though, no clinical features of CCF were observed in this patient. The patient was subsequently referred to another hospital with a neurointerventional radiologist for management. In conclusion, this case shows that the absence of clinical features and negative noninvasive imaging investigation does not exclude the diagnosis of CCF.

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