Direct caroticocavernous fistula and traumatic dissection of the ipsilateral internal carotid artery: endovascular treatment

After severe craniocerebral trauma a 14-year-old boy developed progressive exophthalmos with venous congestion and chemosis, due to a direct caroticoc avernous fistula. Angiography revealed traumatic occlusion of the ipsilater al internal carotid artery and absence of the inferior petrosal sinus. Afte r failure of an approach via the anterior and posterior communicating arter ies, the cavernous sinus was successfully catheterised through the occluded internal carotid artery, and embolisation performed with coils.