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Journal of Korean Neurosurgical Society > Volume 25(10); 1996 > Article
Journal of Korean Neurosurgical Society 1996;25(10): 2115-2121.
Clinical Analysis of Traumatic Carotid-Cavernous Fistula.
Boung Cheul Bae, Chang Hwa Choi, Young Woo Lee
Department of Neurosurgery, School of Medicine, Pusan National University, Pusan, Korea.
Traumatic carotid-cavernous fistula(CCF) is a rare complication of moderate to severe head injury. A series of 15 traumatic carotid-cavernous fistulas has been analyzed and 13 cases have been treated with 3 different methods:direct obliteration through pterional approach(5 cases), ligation of internal, common and external carotid artery in the neck(2 cases), occlusion of CCF with detachable balloon technique(6 cases). The remaining 2 cases were treated by conservative procedures. There were 12 cases(80%) with skull fractures, the majority of which(10 cases) had frontal vault and basal skull fractures. The results of each method were as follows:1) Among the 5 direct obliteration procedure groups, we got satisfactory results in only 2 cases(40%), and the other 2 cases needed additional instantaneous carotid trapping procedures, which corrected the fistula. Internal carotid artery patency was also preserved in 2 cases(40%). 2) Among the 2 cases of carotid trapping group, only 1 case(50%) improved to good. 3) Amo ng the detachable balloon group, 5 cases(83.3%) recovered to good or corrected. Carotid patency was preserved in 4 cases(67.7%). As a result, initial treatment modality of CCF should be detachable balloon technique because of good preservation of carotid patency, better result, simplicity, and safety compared with other operative methods.
Key Words: Traumatic carotid-cavernous fistula; Direct obliteration; Carotid ligation; Detachable balloon technique
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