title: Late intracranial haemorrhage and subsequent carotid-cavernous sinus fistula after fracture of the facial bones.
abstract: Carotid-cavernous sinus fistula is an arteriovenous fistula between the internal carotid artery and the cavernous sinus, and is usually caused by a traumatic tear or a ruptured aneurysm of the cavernous segment of the internal carotid artery. We describe a rare case of delayed intracranial haemorrhage and carotid-cavernous sinus fistula that presented 3 weeks after fracture of the facial bones. The patient developed orbital apex syndrome including ptosis of upper eyelid, pulsatile exophthalmos, chemosis, loss of ocular motility, monocular blindness on the right, and numbness of the right infraorbital region. After transcatheter intra-arterial embolisation, the ptosis and chemosis improved.
authors: Oral & Maxillofacial Surgery, Department of Dentistry, Taichung Veterans General Hospital, No. 1650 Taiwan Boulevard, Sec. 4., Taichung, Taiwan. Electronic address: 0010007@yahoo.com.tw.
authors: Chien-Ming
authors: CM
authors: Chang
authors: Chi-Sheng
authors: CS
authors: Cheng
mesh_terms: D000328:Adult; D001763:Blepharoptosis / Q000209:etiology; D001766:Blindness / Q000209:etiology; D020201:Brain Hemorrhage, Traumatic / Q000209:etiology*; D020216:Carotid-Cavernous Sinus Fistula / Q000209:etiology*; D004487:Edema / Q000209:etiology; D004621:Embolization, Therapeutic / Q000379:methods; D005094:Exophthalmos / Q000209:etiology; D005141:Eyelid Diseases / Q000209:etiology; D005147:Facial Bones / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008335:Mandibular Condyle / Q000293:injuries; D008337:Mandibular Fractures / Q000150:complications; D008440:Maxillary Fractures / Q000150:complications; D009886:Ophthalmoplegia / Q000209:etiology; D009915:Orbit / Q000294:innervation; D009917:Orbital Fractures / Q000150:complications; D012887:Skull Fractures / Q000150:complications*; D015051:Zygomatic Fractures / Q000150:complications
keywords: Carotid-cavernous sinus fistula