切换至 "中华医学电子期刊资源库"
高级检索
中华脑血管病杂志(电子版)

中华脑血管病杂志(电子版) ›› 2024, Vol. 18 ›› Issue (03) : 289 -293. doi: 10.11817/j.issn.1673-9248.2024.03.017

病例报告

自发性颈内动脉海绵窦瘘二例报告及文献复习
张誉中1, 陈蓉1,†()   
  1. 1. 570100　海口，海南医学院第一附属医院神经内科
  • 收稿日期:2024-04-11 出版日期:2024-06-01
  • 通信作者: 陈蓉
  • 基金资助:
    海南省自然科学基金高层次人才项目(2019RC379); 海南省临床医学中心建设项目

Spontaneous internal carotid cavernous sinus fistula: two case reports and literature review

Yuzhong Zhang, Rong Chen†()   

  • Received:2024-04-11 Published:2024-06-01
  • Corresponding author: Rong Chen
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

张誉中, 陈蓉. 自发性颈内动脉海绵窦瘘二例报告及文献复习[J]. 中华脑血管病杂志(电子版), 2024, 18(03): 289-293.

Yuzhong Zhang, Rong Chen. Spontaneous internal carotid cavernous sinus fistula: two case reports and literature review[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(03): 289-293.

颈内动脉海绵窦瘘（carotid-cavernous fistula，CCF）是一种罕见的脑血管疾病，发病率为0.17%~0.27%，其中大部分为外伤性CCF，自发性CCF仅占15%~25%。CCF的临床症状有结膜红肿、搏动或不搏动性突眼、眼眶疼痛、视力下降、复视、斜视等，其特征性体征是可闻及与血管搏动一致的颅内杂音或耳鸣。该疾病诊断的金标准是数字减影血管造影（digital subtraction angiography，DSA），同时它也是确定下一步治疗方案的关键。本文报道了2例自发性CCF患者，并对该疾病进行文献复习及总结，以提升临床医师对该疾病的认知度。

图1 患者1影像学检查图像。眼眶磁共振平扫可见左侧眼球突出，左眼上静脉增粗（图a），左侧颈内静脉迂曲增粗（图b）；CT血管造影可见左侧颈内静脉及左眼上静脉增粗，海绵窦区有漏口（图c）；数字减影血管造影见左侧颈内动脉海绵窦段水平段可见一瘘口，颈内动脉与右侧海绵窦相通，属高流量瘘，Barrow A型（图d）；术后显示右侧颈内动脉海绵窦瘘已完全栓塞（图e）；术后6个月复查DSA提示已达治愈系栓塞（图f）
图2 患者2影像学检查图像。CT血管造影可见左侧眼上静脉增粗（图a）；数字减影血管造影可见左侧颈动脉海绵窦瘘，颈外动脉脑膜支与海绵窦之间的硬脑膜分流（Barrow C型）（图b、c），右侧颈动脉海绵窦瘘（图d）
1
Theaudin M, Saint-Maurice JP, Chapot R, et al. Diagnosis and treatment of dural carotid-cavernous fistulas: a consecutive series of 27 patients [J]. J Neurol Neurosurg Psychiatry, 2007, 78(2): 174-179.
2
Kohli GS, Patel BC. Carotid cavernous fistula [M]. StatPearls. Treasure Island (FL): StatPearls Publishing, 2024: 150-183.
3
Peterson E, Minalyan A, Downey C. Carotid-cavernous fistula in a patient with unilateral periorbital swelling and proptosis initially attributed to possible immunoglobulin G4-related (IgG4-related) disease [J]. Cureus, 2023, 15(5): e39608.
4
Parkinson D. Collateral circulation of cavernous carotid artery: anatomy [J]. Can J Surg, 1964, 7: 251-268.
5
Suh DC, Lee JH, Kim SJ, et al. New concept in cavernous sinus dural arteriovenous fistula [J]. Stroke, 2005, 36(6): 1134-1139.
6
Barrow DL, Spector RH, Braun IF, et al. Classification and treatment of spontaneous carotid-cavernous sinus fistulas [J]. J Neurosurg, 1985, 62(2): 248-256.
7
赵浩, 潘文龙, 沈春森, 等. 自发性颈内动脉海绵窦瘘临床诊治研究进展 [J/CD]. 中华神经创伤外科电子杂志, 2018, 4(1): 50-52.
8
Masson-Roy J, Savard M, Mackey A. Carotid cavernous fistula in a patient with type IV ehlers-danlos syndrome [J]. Can J Neurol Sci, 2017, 44(4): 427-428.
9
Henderson AD, Miller NR. Carotid-cavernous fistula: current concepts in aetiology, investigation, and management [J]. Eye, 2018, 32(2): 164-172.
10
Ono K, Oishi H, Tanoue S, et al. Direct carotid-cavernous fistulas occurring during neurointerventional procedures [J]. Interv Neuroradiol, 2016, 22(1): 91-96.
11
Debrun GM, Viñuela F, Fox AJ, et al. Indications for treatment and classification of 132 carotid-cavernous fistulas [J]. Neurosurgery, 1988, 22(2): 285-289.
12
Meyers PM, Halbach VV, Dowd CF, et al. Dural carotid cavernous fistula: definitive endovascular management and long-term follow-up [J]. Am J Ophthalmol, 2002, 134(1): 85-92.
13
于健, 唐海人, 吕全, 等. 自发性颈内动脉海绵窦瘘继发视网膜中央静脉阻塞1例 [J]. 中国实用眼科杂志, 2004, 22(1): 80.
14
Zhang Y, Zheng H, Zhou M, et al. Teaching neuroimages: carotid-cavernous fistula caused by fibromuscular dysplasia [J]. Neurology, 2014, 82(15): e134-e135.
15
Qi Y, Liu H, Jia J, et al. Endovascular treatment for spontaneous carotid cavernous sinus fistula caused by fibromuscular dysplasia: a rare case report and literature review [J]. Clin Neurol Neurosurg, 2020, 195: 105882.
16
Wong GJ, Pendharkar AV, Lyman KA, et al. Carotid-cavernous fistula treatment in vascular Ehlers-Danlos syndrome: a case report and review of management [J]. Stroke, 2023, 54(8): e403-e406.
17
Oishi A, Miyamoto K, Yoshimura N. Etiology of carotid cavernous fistula in Japanese [J]. Jpn J Ophthalmol, 2009, 53(1): 40-43.
18
Ellis JA, Goldstein H, Connolly ES, et al. Carotid-cavernous fistulas [J]. Neurosurg Focus, 2012, 32(5): E9.
19
Woolen S, Gemmete JJ, Pandey AS, et al. Dural carotid-cavernous fistula presenting with confusion and expressive aphasia [J]. J Clin Neurosci, 2015, 22(11): 1844-1846.
20
de Keizer R. Carotid-cavernous and orbital arteriovenous fistulas: ocular features, diagnostic and hemodynamic considerations in relation to visual impairment and morbidity [J]. Orbit , 2003, 22(2): 121-142.
21
Handzic A, Ahmed SU, Mosimann P, et al. Carotid cavernous sinus fistula supplied by an embryological variant of the ophthalmic artery causing posterior ischemic optic neuropathy and ophthalmoplegia [J]. J Neuroophthalmol, 2023. Online ahead of print.
22
van Rooij WJ, Sluzewski M, Beute GN. Ruptured cavernous sinus aneurysms causing carotid cavernous fistula: incidence, clinical presentation, treatment, and outcome [J]. AJNR Am J Neuroradiol, 2006, 27(1): 185-189.
23
徐萍芝, 冷辉, 胡连生. 以耳鸣耳聋为主要症状的自发性颈内动脉海绵窦瘘1例 [J]. 中国耳鼻咽喉颅底外科杂志, 2004, 10(1): 24, 59.
24
Melanis K, Magoufis G, Spiliopoulos S, et al. Carotid-cavernous fistula: a potential treatable cause of bilateral abducens palsy and conjunctival hyperemia [J]. J Stroke Cerebrovasc, 2024, 33(5): 107623.
25
陈爱林, 戴纯刚, 吴垚, 等. 外伤性颈动脉海绵窦瘘伴颅内出血急诊血管内介入治疗 [J]. 临床神经外科杂志, 2023, 20(4): 445-447, 452.
26
Ma YH, Shang R, Lin S, et al. Case report: delayed quadriplegia from traumatic carotid cavernous fistula: a rare case with perimedullary venous drainage [J]. Front Neurol, 2023, 14: 1224425.
27
Prolo DJ. Dural and carotid cavernous sinus fistulas [J]. Ophthalmology, 1988, 95(8): 1154.
28
黄国栋, 李维平, 宋小莲, 等. 经颅多普勒超声在外伤性颈内动脉海绵窦瘘诊断中的价值 [J]. 中华超声影像学杂志, 2005, 14(5): 362-365.
29
Golnik KC, Miller NR. Diagnosis of cavernous sinus arteriovenous fistula by measurement of ocular pulse amplitude [J]. Ophthalmology, 1992, 99(7): 1146-1152.
30
Chen CCC, Chang PCT, Shy CG, et al. CT angiography and MR angiography in the evaluation of carotid cavernous sinus fistula prior to embolization: a comparison of techniques [J]. AJNR Am J Neuroradiol, 2005, 26(9): 2349-2356.
31
Kai Y, Hamada J, Morioka M, et al. Treatment of cavernous sinus dural arteriovenous fistulae by external manual carotid compression [J]. Neurosurgery, 2007, 60(2): 253-257, discussion 257-258.
32
黄昊, 刘坤, 周丹, 等. 介入治疗创伤性颈内动脉海绵窦瘘39例 [J]. 中国临床神经外科杂志, 2021, 26(3): 193-194.
33
Rahmatian A, Yaghoobpoor S, Tavasol A, et al. Clinical efficacy of endovascular treatment approach in patients with carotid cavernous fistula: a systematic review and meta-analysis [J]. World Neurosurg X, 2023, 19: 100189.
34
Jeong SH, Lee JH, Choi HJ, et al. First line treatment of traumatic carotid cavernous fistulas using covered stents at level 1 regional trauma center [J]. J Korean Neurosurg Soc, 2021, 64(5): 818-826.
35
Tu YK, Liu HM, Hu SC. Direct surgery of carotid cavernous fistulae and dural arteriovenous malformations of the cavernous sinus [J]. Neurosurgery, 1997, 41(4): 798-805, discussion 805-806.
36
Day JD, Fukushima T. Direct microsurgery of dural arteriovenous malformation type carotid-cavernous sinus fistulas: indications, technique, and results [J]. Neurosurgery, 1997, 41(5): 1119-1124, discussion 1124-1126.
37
Barcia-Salorio JL, Soler F, Barcia JA, et al. Stereotactic radiosurgery for the treatment of low-flow carotid-cavernous fistulae: results in a series of 25 cases [J]. Stereotact Funct Neurosurg, 1994, 63(1-4): 266-270.
38
车晶晶, 陈旭, 郭燕军, 等. 双侧自发性颈内动脉海绵窦瘘一例 [J]. 中国现代神经疾病杂志, 2012, 12(2): 220-223.
No related articles found!
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号