{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T13:31:13Z","timestamp":1784208673799,"version":"3.55.0"},"reference-count":35,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Traumatic direct type carotid cavernous fistula (CCF) is an acquired arteriovenous shunt between the carotid artery and the cavernous sinus post severe craniofacial trauma or iatrogenic injury. We reported a 46-year-old woman who had developed a traumatic direct type CCF after severe head trauma with a skull base fracture and brain contusion hemorrhage. The clinical manifestations of the patient included pulsatile exophthalmos, proptosis, bruits, chemosis, and a decline in consciousness. Magnetic resonance imaging (MRI) revealed engorgement of the right superior ophthalmic vein (SOV), perifocal cerebral edema in the right frontal\u2013temporal cortex, right basal ganglia, and brain stem. Digital subtraction angiography (DSA) disclosed a direct type high-flow CCF with an aggressive cortical venous reflux drainage pattern, which was attributed to Barrow type A and Thomas classification type 5. After partial treatment by transvenous coil embolization for the CCF, the residual high-flow fistula with aggressive venous drainage had an unusual rapid spontaneous resolution in a brief period. Therefore, it is strongly recommended to meticulously monitor the clinical conditions of patients and perform brain MRI and DSA at short intervals to determine the treatment strategy for residual CCF after partial endovascular treatment.<\/jats:p>","DOI":"10.3390\/medicina60122011","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T09:30:18Z","timestamp":1733391018000},"page":"2011","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Spontaneous Resolution of an Aggressive Direct Carotid Cavernous Fistula Following Partial Transvenous Embolization Treatment: A Case Report and Review of Literatures"],"prefix":"10.3390","volume":"60","author":[{"given":"Wen-Jui","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Chung Shan Medical University Hospital, Taichung City 402, Taiwan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Yuan","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Chung Shan Medical University Hospital, Taichung City 402, Taiwan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Hsiu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chung Shan Medical University Hospital, Taichung City 402, Taiwan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan-Yun","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New Taipei Municipal Tu-Cheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City 236, Taiwan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4523-2422","authenticated-orcid":false,"given":"Tao-Chieh","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chung Shan Medical University Hospital, Taichung City 402, Taiwan, China"},{"name":"School of Medicine, Chung Shan Medical University, Taichung City 402, Taiwan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.nec.2004.08.004","article-title":"Carotid cavernous fistulas: Anatomy, classification, and treatment","volume":"16","author":"Ringer","year":"2005","journal-title":"Neurosurg. 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Int."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/12\/2011\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:47:55Z","timestamp":1760114875000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/12\/2011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,5]]},"references-count":35,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["medicina60122011"],"URL":"https:\/\/doi.org\/10.3390\/medicina60122011","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,5]]}}}