栓塞治疗颈动脉海绵窦瘘的良好效果

目的：报告外伤后颈动脉海绵窦瘘患者应用螺圈栓塞的成功经验。方法：连续病例。结果：两名颈动脉海绵窦瘘（CCF）患者成功接受了螺圈栓塞治疗。他们分别在机动车事故后2wk和4mo出现CCF的临床症状。一名患者视力良好但眼内压（10P）升高，另一名则视力低下伴有临界眼内压。CCF的诊断均得到脑血管造影证实，采用螺圈栓塞治疗后两名患者视力恢复正常，在未用任何抗青光眼药物前提下眼压降至正常范围。CCF的症状诸如眼球突出，眼肌麻痹，结膜充血水肿，眼眶杂音及眼底改变也随之消失。结论：颈动脉海绵窦瘘宜早诊断和治疗以避免发生视力丧失严重并发症的发生，血管内栓塞是当代治疗选择。

Excellent results in post embolization patients wit] ~ ~arotid cavernous fistula

AIM. To report cases of carotid cavernous fistula in post traumatic patients successfully treated with coil embolization. METHODS： Two cases of direct carotid cavernous fistula （CCF） underwent successful coil embolization. Both patients presented with clinical features of CCF following motor vehicle accident at two weeks and four months. One patient had good visual acuity with raised intraocular pressure （IOP） and the other had poor vision with borderline IOP. The diagnosis was confirmed with cerebral angiography. Coil embolization were performed in both cases. RESULTS： After the procedure the vision was back to normal and lOP came down to normal range without antiglaucoma. The features of CCF were also resolved, which included proptosis, ophthalmoplegia, chemotic conjunctiva, orbital bruit and fundus changes. CONCLUSION： Carotid cavernous fistula should be diagnosed and treated early to prevent serious ocular complication of vision loss. Endovascular embolization is the current treatment of choice.