颅内段颈内动脉创伤的诊断及血管内治疗

目的 探讨颅内段颈内动脉创伤的诊断和血管内治疗的临床价值.方法 11例颅内段颈内动脉病变的患者应用选择性全脑造影进行诊断,10例行颈内动脉栓塞治疗.所有资料采用回顾性分析.结果 3例颈内动脉假性动脉瘤,4例颈内动脉-海绵窦瘘,1例颈内动脉假性动脉瘤伴颈内动脉-海绵窦瘘及1例巨大蛇形动脉行球囊颈内动脉完全性栓塞,1例颈内动脉-海绵窦瘘行电解可脱式弹簧圈保留颈内动脉栓塞,1例放弃治疗.随访4个月～7年,1 0例颈内动脉病变的患者痊愈.结论 选择性全脑造影是外伤性颈内动脉损伤首选诊断方法,血管内治疗安全有效.

Diagnosis and endovascular treatment of injury of the intracranial portion of the internal carotid artery

OBJECTIVE To study the diagnosis and clinical value of endovascular treatment in the trauma of the intracranial portion of the internal carotid artery. METHODS The clinical data of all the 11 patients were retrospectively analyzed. Selective arteriography of the brain was carried out in 11 patients with traumas in intracranial portion of the internal carotid artery and embolic treatment was performed in 10 cases. RESULTS Complete embolization of internal carotid artery with detachable balloon occurred in 9 cases, among which 3 cases were associated with pseudo-aneurysm in internal carotid artery, 4 with carotid-cavernous fistula, 1 with of pseudo- aneurysm with carotid-cavernous fistula, and 1 with giant snakelike aneurysms. One case employed incomplete embolization of preserving internal carotid artery with Guglielmi detachable coil, and another case abandoned treatment. The duration of following-up was between 4 months and 7 years and 10 cases of trauma in internal carotid artery were cured. CONCLUSION Selective arteriography in brain should be the first choice in the diagnosis of trauma in internal carotid artery. Endovascular intervention treatment is safe and effective.