Carotid Cavernous Sinus Fistula: A Complication of Craniofacial Trauma – A Case Report

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Carotid Cavernous Sinus Fistula: A Complication of Craniofacial Trauma – A Case Report

H Muhammad, SMSJ Al-Idrus, AN Omar: Carotid Cavernous Sinus Fistula: A Complication of Craniofacial Trauma – A Case Report. Mal. J. Oral Maxillofac. Surg. 2016; 14: 18–22.

Abstract: Carotid cavernous sinus fistula (CCSF) is an abnormal vascular interconnection between a branch of the carotid artery and the cavernous sinus. This is an uncommon complication of craniofacial injuries, as it occurs in only 0.17-0.27% of cases. The complication of CCSF, although infrequent, are potentially life- threatening. They may include intracranial haemorrhage, worsening pulsatile proptosis, exposure keratitis, neovascular glaucoma, blindness, cranial nerve deficits and fatal epistaxis. A case of CCSF in a craniofacial trauma patient is presented in this report. He sustained intracranial injury as well as base of skull, mastoid bone, mandibular fractures and developed worsening proptosis, bruit and decreasing visual acuity over the same eye and a case of CCSF was diagnosed. Embolisation was performed and proptosis, visual acuity and eye movement in all directions improved except lateral gaze. The aim of this report is, to emphasize the need for thorough observation and examination of maxillofacial trauma patients, because, oral & maxillofacial surgeons may observe signs in the early stages, and therefore, can contribute to an accurate diagnosis and ensure correct treatment so as to achieve a successful result.