A case of traumatic carotid-cavernous sinus fistula associated with mandibular condyle fracture

DOI Web Site 10 References
  • GOTO Toshiyuki
    First Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry Department of Dentistry and Oral Surgery, Kasukabe Municipal General Hospital
  • NAKANISHI Koji
    Department of Dentistry and Oral Surgery, Kasukabe Municipal General Hospital
  • ASAKA Yosuke
    Department of Dentistry and Oral Surgery, Kasukabe Municipal General Hospital
  • SATO Takako
    First Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry
  • TAKEDA Akio
    Department of Dentistry and Oral Surgery, Kasukabe Municipal General Hospital
  • OHKI Hidero
    First Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry

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  • 下顎骨関節突起骨折に合併した外傷性頸動脈海綿静脈洞瘻の1例
  • カガクコツ カンセツ トッキ コッセツ ニ ガッペイ シタ ガイショウセイ ケイドウミャク カイメン ジョウミャクドウロウ ノ 1レイ

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Abstract

Traumatic carotid-cavernous sinus fistula (traumatic CCF) is a rare disorder in which the internal carotid artery is torn and forms an abnormal interconnection with the cavernous sinus as a result of craniofacial injuries. We describe a case of traumatic CCF occurring during follow-up after open reduction and internal fixation of a mandibular fracture. The patient was a 56-year-old woman who was injured in a motorcycle accident. She had a mandibular fracture without skull base or midface fracture. Conjunctival hyperemia of the left eye, exophthalmos, and vascular bruits in the palpebral region developed 87 days after injury. Brain computed tomography revealed left exophthalmos and abnormalities in the cavernous sinus region, as well as superior ophthalmic vein distention. Left carotid angiography revealed shunt flow into the cavernous sinus, leading to a diagnosis of CCF. Left internal artery occlusion was performed using a Guglielmi detachable coil. The present case suggests that delayed cerebrovascular disorder can occur during postoperative follow-up, even in patients with mandibular fracture alone.

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