DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.089

Pages: 2560-2563

Carotid-cavernous fistulas (CCFs) are rare vascular anomalies involving abnormal communication between the carotid arterial system and the cavernous sinus. Direct CCFs, often post-traumatic, occur mainly in young males after craniofacial trauma. We report the case of a 28-year-old male presenting with progressive pulsatile exophthalmos and eyelid edema following a road traffic accident. Non-contrast CT and CT angiography identified multiple craniofacial fractures, early enhancement of the superior ophthalmic vein, and asymmetrical bulging of the cavernous sinus, confirming a direct post-traumatic CCF. This case emphasizes the essential role of CT imaging, as a non-invasive tool, in early detection and management planning of post-traumatic CCFs, particularly in settings where immediate angiography may not be available.