A rare presentation of post-traumatic high-flow carotid–cavernous fistula with contralateral ocular symptoms: Successful endovascular parent vessel occlusion

Abstract

Background

Carotid–cavernous fistula (CCF) is an abnormal communication between the carotid arterial system and the cavernous sinus. High-flow direct CCFs are most commonly post-traumatic and usually present with ipsilateral ocular symptoms. Contralateral ocular manifestations are rare, reported in only 5–10% of cases. We report a rare and challenging case of a post-traumatic high-flow right CCF presenting predominantly with contralateral eye symptoms, successfully managed with endovascular embolisation and parent vessel occlusion of the right internal carotid artery (ICA), resulting in complete fistula closure and favorable clinical outcome.