Endovascular therapy of traumatic carotid-cavernous fistulas.

Traumatic carotid-cavernous fistulas (CCF) are capable of causing a large variety of signs and symptoms, including visual loss, glaucoma, chemosis, exophthalmos, and orbital cranial nerve palsies. The high pressure in the veins that normally drain the globe can cause them to engorge and produce local compression of adjacent structures. At present, endovascular closure of the fistula is the treatment of choice, particularly in patients with progressive neurologic deterioration. Endovascular repair of CCF most commonly involves the use of detachable balloons, although coils are also used. Effective closure of the fistula leads to rapid resolution of the symptoms.