Guilherme Brasileiro de Aguiar, Mario Luiz Marques Conti and Jose Carlos Esteves Veiga
The Carotid-Cavernous Direct Fistula (CCF) is a high-flow injury resulting from the wall laceration of the cavernous segment of the internal carotid artery and its subsequent communication with the cavernous sinus [1]. The vast majority of direct CCF is traumatic but direct posttraumatic CCF represents a rare entity, occurring in only 0.17 to 1.01% of all Traumatic Brain Injury (TBI) [1,2]. Clinical presentation may involve impairment of cranial nerves III, IV, V and VI, causing paralysis on the extrinsic eye movement and diplopia, besides the emergence of headache, retro-orbital pain, chemosis and proptosis and even intracranial hemorrhage [2].
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