Traumatic carotid-cavernous fistula in a multiple facial fractures patient: case report and literature review

Delayed contralateral traumatic carotid cavernous fistula after craniomaxillofacial fractures

A carotid-cavernous sinus fistula is a rare condition in which an abnormal communication exists between the internal or external carotid artery and the cavernous sinus. It typically occurs within a few weeks after craniomaxillofacial trauma. In most cases, the carotid-cavernous sinus fistula occurs on the same side as the craniomaxillofacial fracture. We report a case of delayed carotidcavernous sinus fistula that developed symptoms 7 months after the craniomaxillofacial fracture. The fistula developed on the side opposite to that of the craniomaxillofacial fracture. Based on our experience with this case, we recommend a long follow-up period of 7–8 months after the occurrence of a craniomaxillofacial fracture. We also recommend that the follow-up should include consideration of the side contralateral to the injury.

Bilateral Traumatic Caroticocavernous Fistulas: A Case Report and Review of the Literature

A traumatic caroticocavernous fistula (CCF) is an acquired, abnormal communication between the internal carotid artery and the cavernous sinus, secondary to trauma. This rare condition can initially be misdiagnosed, because its presentation shares features common to those of facial trauma, which can result in serious complications. We describe a case of bilateral CCF in an adult patient after a road traffic accident.

Orbital Compartment Syndrome despite Significant Traumatic Expansion of the Orbital Cavity

Periorbital injury can present with various permutations of bone trauma, soft-tissue edema, and hematomas that might involve proptosis and restricted motility. We report a case of a 32-year-old patient who sustained a traumatic orbital compartment syndrome simultaneously with a large, significantly displaced, orbital-floor blow-out fracture. Clinical signs consistent with both conditions were elicited. The initial management was as for orbital compartment syndrome. The clinical diagnosis was confirmed with computed tomographic imaging. This is an unusual and unexpected presentation. It would be expected that a hemorrhage would self-decompress in the presence of a large fracture. Physicians should be aware that such a combination of pathology might arise. Physicians likely to encounter periocular trauma should be prepared for its management: urgent lateral canthotomy and cantholysis. Differential diagnoses of periocular trauma are compared and contrasted.