Abstract
A 50-year old woman came with the presentation of comatose with a subdural hematoma due to road traffic accident. She underwent tracheostomy after she developed ventilator-associated pneumonia. Within 72 hours of the procedure she developed tracheo-innominate fistula which usually develops in 1-2 weeks and is quite rare. Although the defect was repaired with a saphenous vein patch, the bleeding continued and no improvements were seen.

Key words: subdural hematoma, tracheostomy, pseudo-aneurysm, tracheo-innominate fistula