Abstract
A 55-year-old woman visited our hospital with exophthalmos and hyperemia of her right eye. An angiogram demonstrated a high-flow right carotid-cavernous fistula (CCF) which was draining into the right superior ophthalmic and facial vein. We performed trans-arterial embolization using various kinds of coils, and completely obliterated the CCF. The CCF seemed to result from a rupture of a petrous portion aneurysm of the right internal carotid artery. Right internal carotid angiogram eight months after the embolization showed neither recanalization of the CCF nor coil compaction. Her symptoms disappeared within 12 months after the embolization. CCF caused by the rupture of an internal carotid artery aneurysm is a rare condition. High-flow CCFs with a large amount of arterio-venous shunt rarely resolve spontaneously. An endovascular approach is a useful treatment option for these CCFs.
