INTRODUCTION: Persistent trigeminal artery is the most frequent embryonic communication between the vertebrobasilar and carotid systems. To the best of our knowledge, posttraumatic trigeminal-cavernous fistula is rarely reported in the literature. CASE PRESENTATION: We present a 47-year-old man with posttraumatic trigeminal-cavernous fistula, which we treated using Onyx embolization. CONCLUSION: Even though preservation of the parent artery is generally considered a desirable goal in fistula treatment, in special cases such as Salzmann type 2 anatomy plus a unique fistulous orifice accompanied by external carotid-cavernous fistula, it is required to embolize the persistent trigeminal artery and cavernous sinus.
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