Case Report: Management of Traumatic Carotid-Cavernous Fistulas in the Acute Setting of Penetrating Brain Injury

Traumatic carotid-cavernous fistulas (tCCFs) after penetrating brain injury (PBI) have been uncommonly described in the literature with little guidance on optimal treatment. In this case series, we present two patients with PBI secondary to gunshot wounds to the head who acutely developed tCCFs, and...

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Bibliographic Details
Published in:Frontiers in neurology 2022-02, Vol.12, p.715955
Main Authors: Loggini, Andrea, Kass-Hout, Tareq, Awad, Issam A, El Ammar, Faten, Kramer, Christopher L, Goldenberg, Fernando D, Lazaridis, Christos, Mansour, Ali
Format: Article
Language:English
Subjects:
endovascular intervention
neurocritical care
Neurology
penetrating brain injury
traumatic carotid cavernous fistula
traumatic cerebrovascular injury
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Summary:Traumatic carotid-cavernous fistulas (tCCFs) after penetrating brain injury (PBI) have been uncommonly described in the literature with little guidance on optimal treatment. In this case series, we present two patients with PBI secondary to gunshot wounds to the head who acutely developed tCCFs, and we review the lead-up to diagnosis in addition to the treatment of this condition. We highlight the importance of early cerebrovascular imaging as the clinical manifestations may be limited by poor neurological status and possibly concomitant injury. Definitive treatment should be attempted as soon as possible with embolization of the fistula, flow diversion via stenting of the fistula site, and, finally, vessel sacrifice as possible therapeutic options.
ISSN:1664-2295
1664-2295
DOI:10.3389/fneur.2021.715955