Case Report
Volume 19 Issue 4 - 2020
Delayed Carotid Cavernous Fistula after Craniomaxillofacial Trauma
Humberto Fernández-Olarte1, Lozano-Gutiérrez Erika2, Andrés Gómez-Delgado3* and Juan Manuel Morales Fernández4
1Oral and Maxillofacial Surgeon and Director, Oral and Maxillofacial Surgery Residency Program, Universidad El Bosque and Head, Oral and Maxillofacial Surgery Department, Clínica El Bosque and Cranio-Maxillofacial Surgery Department, Hospital Simon Bolívar, Bogotá, Colombia
2Oral and Maxillofacial Surgeon, Centro Médico Santa Teresa, Cali, Colombia
3Oral and Maxillofacial Surgeon, Hospital San Juan de Dios and Hospital UNIBE, San José, Costa Rica and Professor, Oral and Maxillofacial Surgery Residency Program, Universidad El Bosque, Bogotá, Colombia
4Oral and Maxillofacial Surgeon, Private Practice, Popayán - Cauca, Colombia
*Corresponding Author: Andrés Gómez-Delgado, Oral and Maxillofacial Surgeon, Hospital San Juan de Dios and Hospital UNIBE, San José, Costa Rica and Professor, Oral and Maxillofacial Surgery Residency Program, Universidad El Bosque, Bogotá, Colombia.
Received: February 03, 2020; Published: March 19, 2020


The carotid-cavernous fistula (CCF) is an abnormal connection between the carotid artery and the cavernous sinus, which causes a sharp change in the direction and distribution of blood flow, that can have consequences such as severe alterations of the brain and orbits, or even death. CCF can develop after craniomaxillofacial trauma or spontaneously, however, it has also been associated with arterial hypertension and connective tissue diseases. Characteristic signs include pulsatile exophthalmos, murmur and venular dilation with chemosis (Dandy's triad). The purpose of this study is to present a clinical case of a direct traumatic carotidocavernous fistula, its diagnosis, management and complications.

Keywords: Carotid Cavernous Fistula (CCF); Craniomaxillofacial Trauma


  1. Fattahi T., et al. “Traumatic carotid-cavernous fistula: pathophysiology and treatment”. Journal of Craniofacial Surgery 14.2 (2003): 240-246.
  2. Alza A., et al. “Fístula carotídeo-cavernosa”. Revista del Hospital Privado de Comunidad 7 (2004): 1.
  3. Karaman E., et al. “Carotid-Cavernous Fistula After Functional Endoscopic Sinus Surgery”. Journal of Craniofacial Surgery 20.2 (2009): 556-558.
  4. Barrow DL., et al. “Classification and treatment of spontaneous carotid-cavernous sinus fistulas”. Journal of Neurosurgery 62.2 (1985): 248-256. 
  5. Biousse V., et al. “The ophthalmology of intracranial vascular abnormalities”. American Journal of Ophthalmology 125.4 (1998): 527-544.
  6. Ringer AJ., et al. “Carotid cavernous fistulas: Anatomy, classification, and treatment”. Neurosurgery Clinics of North America 16.2 (2005): 279-295.
  7. Cejas C., et al. “Ecografía y Doppler ocular y orbitario”. First Edition, Editorial Journal, Madrid (2004): 179-183.
  8. Terceros-Almanza LJ., et al. “Development of carotid cavernous fistula after traumatic brain injury”. Medicina Intensiva 39.9 (2015): 581-583.
  9. Helmke K., et al. “The direct carotid cavernous fistula: A clinical, pathoanatomical, and physical study”. Acta Neurochirurgica 127.1-2 (1994): 1-5. 
  10. Stojčić M., et al. “Bilateral carotid-cavernous fistula presented with unilateral Symptomatology”. Vojnosanit Pregled 75 (2018): 940-943.
  11. Sur S., et al. “Multimodal Management of Carotid-Cavernous Fistulas”. World Neurosurgery 133 (2020): e796-e803.
Citation: Humberto Fernández-Olarte., et al. “Delayed Carotid Cavernous Fistula after Craniomaxillofacial Trauma”. EC Dental Science 19.4 (2020): 107-113.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

August Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the August issue of respective journals and can be viewed in the current issue pages.

Submission Deadline for September Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the September issue of respective journals. Submissions are accepted on/before August 21, 2020.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to