Bilateral traumatic caroticocavernous fistulae: total resolution following unilateral occlusion

Balloon occlusion is the accepted treatment for direct posttraumatic caroticocavernous fistula. We present a case of bilateral traumatic fistulae associated with a pseudoaneurysm. Resolution of both fistulae occurred following treatment of one of them by balloon occlusion of the internal carotid artery. This case highlights the importance of considering a more conservative approach to bilateral fistulae or those associated with a pseudoaneurysm. We review other treatment options.