TRAUMATIC CAROTID-CAVERNOUS SINUS FISTULA - SERIAL ANGIOGRAPHIC STUDIES FROM THE DAY OF TRAUMA

BACKGROUND AND PURPOSE: The purpose of this study was to ascertain the early angiographic features characteristic of traumatic carotid caver nous sinus fistulas (CCFs). METHODS: Eight patients with severe cranio facial injuries underwent emergency diagnostic and therapeutic angiogr aphy for intractable oronasal bleeding, starting on an average of 6.7 hours after trauma. Carotid angiograms and the clinical manifestation of traumatic CCFs were then reviewed retrospectively to determine char acteristic angiographic features. RESULTS: In four of the eight patien ts, no arteriovenous fistulas were found in the cavernous sinuses and symptomatic CCF did not occur during the follow-up period. In the rema ining four patients, dural CCFs (Barrow type B) were observed, unilate rally in three patients and bilaterally in one, One of these four pati ents subsequently became symptomatic and required transarterial coil e mbolization. CONCLUSION Traumatic dural CCFs are frequently observed i n the early stage of severe craniofacial trauma, if investigated. Alth ough their spontaneous disappearance is known, some of these do become symptomatic and need treatment.