Spontaneous Healing of a Carotid Cavernous Anastomosis

Abstract

A case is reported of a traumatic middle meningeal arteriovenous fistula, which was formed on the contralateral side to the head injury without a skull fracture and was no longer demonstrable on the repeated angiogram after 35 days without any surgical intervention. Possible mechanisms of fistula formation and its spontaneous closure are discussed.

Case Details

Personal Characteristics

A female patient, 40 years old

Clinical Characteristics

Serious craniocerebral trauma with fractured cranium, unconsciousness, vomiting, traces of blood, nose bleeding, excretion of fluid from the left auditory canal, diffuse swelling of the face, ecchymosis around both eyes, pulse noise in the crown of the head, redness of the sclera, bulging of the right eye, sharp headache in the temple area over the right eye, cloudy vision, right sided exophthalmos with edema and hyperemia of the upper brow and conjunctiva, no pupillary reflex in the right eye, limited movement of the bulbous oculi, hypertension in the area innervated by the second branch of the trigeminal nerve on the right side, acute inflammation in the area of the right eye, acute hemoptysis of the conjunctiva, prolapse in sight in the right eye, inflammation of the right eye, hemoptysis of the lower temple, internal pressure drop, retinal vessels emptied out, blood vessel ruptures in the area of the yellow spot

Remission Characteristics

Cessation of the pulsating sound in the head, regression of hemoptysis and protrusion of the right eye

Treatment & Mechanisms

Proposed Remission Mechanisms

Possible variations of thrombogenesis in the venous and arterial bed, along with isolated obliteration with the limits of the defective arterial wall

Clinical Treatment

Carotid angiography

Additional Notes

The patient had suffered a serious craniocerebral trauma with fractured cranium during an automobile accident. The patient was released May 29, 1962.