A case of a traumatic trigeminal-cavernous fistula occluded by coil embolization.

BACKGROUND

A trigeminal artery as the most common persisting embryonic carotid-basilar anastomosis is found in up to .2% of adults. In rare instances, trigeminal-cavernous fistulas develop either spontaneously or after a trauma.

RESULTS

We present a 16-year-old patient with a traumatic trigeminal-cavernous fistula (Saltzmann type 2), which was successfully treated by interventional occlusion of the persistent trigeminal artery. After intervention, clinical symptoms (chemosis, right-temporal bruits, and sixth nerve palsy) resolved.

DISCUSSION: In this case, fistula occlusion was achieved by coil embolization with only 4 coils placed directly at the rupture point of the trigeminal artery but not into the cavernous sinus. Thus, the cavernous sinus was preserved in function and structure. Special anatomy and interventional peculiarities of this unique case are described in detail.