Carotid-cavernous fistula (CCF) refers to the rupture of the internal carotid artery itself or its branches in the cavernous segment of the cranial sinus, resulting in an abnormal arterial and venous communication with the cavernous sinus, leading to an increase in pressure in the cavernous sinus and a series of clinical manifestations. Traumatic carotid-cavernous fistula (TCCF), such as skull base fracture laceration, bone fragment puncture, foreign body penetration injury, firearm injury, and spontaneous CCF, such as aneurysm rupture, arteritis, atherosclerosis, and spontaneous CCF during pregnancy, account for more than 75% of cases. CCF Typical clinical manifestations are as follows: (1) pulsatile proptosis, caused by increased pressure in the cavernous sinus, which affects the return of the ophthalmic vein; (2) tremor and murmur, which severely affects the patient’s work and rest and is the main reason for the patient’s visit; (3) bulbar conjunctival edema and congestion, caused by restriction of the return of the ophthalmic vein, which is one of the reasons for the patient’s visit; (4) restriction of eye movements (uncommon), caused by restriction of the cranial nerve passing through the cavernous sinus. (6) neurological deficits and subarachnoid hemorrhage, which appear early in the trauma and are related to the site and extent of the trauma; (7) fatal rhinorrhea, which may be related to a pseudoaneurysm. The diagnosis of CCF is mainly based on its typical clinical presentation and typical ocular signs, in addition to a clear history of craniocerebral trauma to confirm the diagnosis. Three types of medical imaging examinations: ultrasound of the eye, cranial CT and/or MRI can reveal dilated supraocular veins, extraocular muscle hypertrophy, and thickened intraorbital fat pads; some CT or MRI examinations also show dilated rustic cavities, which can be used as an auxiliary diagnosis. Treatment of CCF is aimed at protecting vision, eliminating murmurs, retracting the eye and preventing cerebral ischemia or hemorrhage. 1974 Serbinenko first reported the successful treatment of TCCF with detachable balloon embolization. For small fistulae with inaccessible balloons, embolization with microspring coils can be used; if the arterial approach fails or fails, the fistula can be embolized by the venous approach; for fistulae in which multiple balloons are placed but the fistula cannot be embolized, occlusion of the internal carotid artery can be considered. For TCCF, such as those caused by traumatic brain injury and skull base fracture, balloon rupture may easily cause embolization failure or make treatment more difficult. Treatment. After embolization treatment, the patient should be given continuous fluids to promote urination in order to excrete the contrast agent as soon as possible and reduce irritation, while antibiotics should be applied to prevent infection and the lower limb on the puncture side should be braked for 24h to prevent local bleeding, and dehydration, hormonal drugs and symptomatic treatment should be applied according to the situation.