Kaplan et al. International Journal of Emergency Medicine 2012, 5:10 http://www.intjem.com/content/5/1/10 Page 3 of 5 Figure 2 MRI of the brain with contrast. Increased flow in the left cavernous sinus and engorgement of the left ophthalmic vein. Discussion We report a rare condition encountered in the emergency department of a post-traumatic carotid-cavernous fistula. CCFs are formed when there is leakage of arterial flow from the carotid artery into the venous system of the cavernous sinus. This pathological connection leads to Figure 3 Cerebral angiography images. (Left) Angio-catheterization of the left internal carotid artery (ICA) showing a CCF (arrow). (Right) Post- coil embolization (arrow) of the left CCF.