This report documents the treatment of a traumatic
aneurysm of the supraclinoid internal carotid artery (ICA) that was associated with a
carotid-cavernous fistula (CCF), which appeared following
closed head trauma. This life-threatening lesion, which is very rare, required aggressive management achieved using intravascular
stents and coils. A 19-year-old man presented with severe traumatic intracerebral and subarachnoid
hematoma after he had suffered a severe
closed head injury in a motor vehicle accident. Cerebral angiography performed 11 days after the injury demonstrated a traumatic
aneurysm and severe narrowing of the right supraclinoid ICA, which was consistent with a dissection-induced
stenosis associated with a direct CCF. Both lesions were successfully obliterated with preservation of the parent artery by using
stents in conjunction with coils. Follow-up angiography obtained 7 months postoperatively revealed persistent obliteration of the
aneurysm and CCF as well as patency of the parent artery. The patient remained asymptomatic during the clinical follow-up period of 14 months. Endovascular treatment involving the use of a
stent combined with coils appears to be a feasible, minimally invasive option for treatment of this hard-to-treat lesion.