外伤性颈内动脉海绵窦瘘临床观察

目的 分析6例外伤性颈内动脉海绵窦瘘的临床特点。诊断，鉴别诊断和治疗，方法 回顾性地对外伤性颈内动脉海绵窦瘘的致伤原因，致伤物，就诊时间，临床特点，诊断，鉴别诊断及治疗效果进行讨论。结果 本文2例行股动脉插管可脱球囊栓塞术后第二天杂音消失，眼球突出明显好转。结论 早期诊断，及时治疗愈后较好。     

外伤性颈内动脉海绵窦瘘8例分析

目的探讨外伤性颈内动脉海绵窦瘘(TCCF)的临床特点及血管内栓塞治疗的价值与效果。方法回顾性地分析8例外伤性颈内动脉海绵窦瘘患者的眼部表现、影像学特点及血管内栓塞治疗情况。结果8例患者均诊断正确。8例TCCF通过DSA技术,采用可脱性球囊行血管内栓塞治疗,7例成功(成功率87.5%),1例采用弹簧圈堵塞近瘘口处血管。治疗后全部病例均获成功,临床症状和体征消失,无1例复发。结论特征性眼部表现及超声、CT、MRI可确诊TCCF,DSA检查及血管内栓塞技术是目前TCCF最理想的诊断和治疗方法。     

外伤性颈动脉-海绵窦瘘诊断及血管内栓治疗

目的：探讨利用介入神经放射技术对外伤性颈动脉－海绵窦瘘在眼科的诊断和治疗的应用价值。方法：对外伤性颈动脉－海绵窦瘘高度怀疑的病人,利用德国产MULTISTAR PLUS／TOP数字减影血管造影仪,经股动脉插管选择性全脑血管造影,明确诊断及瘘口部位,行血管内可脱性球囊栓塞治疗。结果：眼部及颅内血管杂音消失,眼部充血明显好转,突眼恢复正常,眼球运动功能明显改善,眼底视盘清晰,例一视神经萎缩视力无提高,例二视力无进一步损害。结论：明确的颅脑外伤史,特征性的眼部表现,先进的介入神经放射技术的利用,是眼科诊断和治疗外伤性颈动脉－海绵窦瘘的有效的方法。     

颈动脉海绵窦瘘的眼部表现与血管内治疗

目的：分析颈动脉海棉窦瘘的眼部临床特点，评价血管内治疗的效果。方法：回顾分析126例经全脑血管造影证实为颈动脉海绵窦瘘患的病史、眼部表现、临床特点及进行的可脱性球囊栓塞治疗。结果：手术1次性栓塞成功112例(88．9％)，14例行2次栓塞。术后无并发症。98例视力较术前提高1～4行(国际标准视力表)。术后眼部淤血肿胀、眼球突出度均明显减轻或消失，眼球运动恢复正常，复视消失，视网膜出血吸收。眼部血管杂音全部消失，术后脑血管造影，瘘口均封闭。结论：对于颈动脉海绵窦瘘应及时治疗，尽快改善眼部淤血状态，以利于视功能恢复。血管内栓塞是目前治疗颈动脉海绵窦瘘最为理想的方法。     

颈内动脉海绵窦瘘的眼部表现及介入治疗

目的探讨颈内动脉海绵窦瘘（CCF）的眼科诊断和介入治疗。方法回顾性分析6例CCF的临床表现和诊断,以及应用可脱性球囊及GDC弹簧圈栓塞治疗的临床资料。结果6例CCF的瘘口完全闭塞,临床症状消失。结论CCF治疗的关键在于及时的诊断以及闭塞瘘口。     

外伤性颈内动脉—海绵瘘的DSA血管内治疗

目的：探讨数字减影血管造影（Digital subtraction angiography,DSA)及血管内治疗对外伤性颈内动脉-海绵瘘（Traumatic carotid-cavernous fistula,TCCF)的诊断及治疗价值。方法：对9例以搏动性突眼为主要症状的海绵窦瘘患者行DSA检查及行可脱性球囊血管内栓塞治疗总结分析。结果：9例患者均成功栓塞瘘口且保留载瘤动脉通畅。结论：DSA检查和血管内栓塞治疗是TCCF理想的诊断与治疗方法。     

数字减影脑血管造影对海绵窦瘘的诊断及其血管内治疗

目的 探讨全脑动脉数字减影血管造影（ｄｉｇｉｔａｌｓｕｂｔｒａｃｔｉｏｎａｎｇｉｏｇｒａｐｈｙ,ＤＳＡ）血管内治疗,对以搏动性眼球突出为主要表现的颈动脉海绵窦瘘（ｃａｒｏｔｉｄｃａｖｅｍｏｕｓｓｉｎｕｓｆｉｓｔｕｌａ,ＣＣＦ）的诊断及治疗价值。方法 对１５例海绵窦瘘患者行ＤＳＡ,１２例行可脱性球囊,微螺圈血管内栓塞治疗。结果 １５例中,１２例为高流量单侧颈内动脉型ＣＣＦ,３例为低流量单侧颈外动脉     

颈动脉海绵窦瘘的眼部表现与血管内治疗

目的 分析颈动脉海绵窦瘘的临床特点。评价血管内治疗的效果。方法 回顾分析１２例经全盘离血管造影证实为颈内动态海绵窦瘘患者的病史、眼部表现、临床检查的特点及进行可脱性球囊栓塞的疗效。结果 １２例患者１次栓塞成功者１０例（８３．３％）,２例行２次栓塞,术后无并发症,１例术前失明,术后１ｗｋ视力恢复至眼前手动。１０例视力较术前提高１～４行（Ｓｎｅｌｌｅｎ表）。术后眼部瘀血肿胀、眼球突出度均明显减轻或消失。眼球运动恢复正常,复视消失,视网膜出血吸收,眼部血管杂音全部消失。术后全脑血管造影复查,瘘口均封闭。结论 对于颈内动脉海绵窦瘘应及时治疗,尽快恢复视功能。彩色多普勒超声、ＣＴ、ＤＳＡ是诊断本病的常用手段。血管内栓塞是目前治疗颈动脉海绵窦瘘最为理想的方法。     

颈动脉—海绵窦瘘血管造影诊断与栓塞治疗

颈动脉—海绵窦瘘是由于颈内动脉或颈外动脉分支与海绵窦之间的异常交通而引起的神经—眼科综合征。其病因多为外伤性，也可为自发性或先天性。由于其瘘口部位特殊，治疗方法颇多，最佳的治疗方法是既能可靠地封闭瘘口，又能保持颈内动脉的通畅，而血管内栓塞是较理想的治...     

颈动脉海绵窦瘘介入治疗观察

目的探讨颈动脉海绵窦瘘介入治疗效果。方法对8眼(8例)颈动脉海绵窦瘘采用介入治疗并随访分析。结果7例经颈内动脉置入成功。1例经颈内动脉失败后，经眼上静脉置入成功。术后症状逐渐减轻，1～6月随访观察症状体征消失，瘘口消失，血管造影证实颈内动脉通畅，海绵窦不显影。结论颈动脉海绵窦瘘介入治疗安全性高，创伤轻，恢复快，并发症少。是一种较为理想的治疗方法。     

颈动脉一海绵窦瘘

目的：探讨31例TCCF及5例SCCF的临床特点与疗效。方法：回顾性地分析该病的诊断和治疗方法。结果：24例TCCF经血管内栓塞治疗后有22例。症状及体征消退，瘘口消失(治愈率91．7％)。好转2例(8．3％)，症状和体征减轻，瘘口基本闭塞。5例SCCF经保守治疗。效果良好。结论：DSA检查及血管内栓塞技术是较理想的诊断及治疗方法。     

颈动脉海绵窦瘘的影像学诊断及血管内栓塞治疗

目的 评价颈动脉海绵窦瘘(CCF)应用影像学诊断及血管内栓塞治疗的价值。方法 分析23例颈动脉海绵窦瘘患者的眼部表现、影像特点。进行血管内栓塞治疗。结果 全部病例最终获正确诊断。19例行血管内栓塞术者，16例1次成功，2例行2次栓塞成功，1例失败。术后视力除3例术前失明未恢复外，16例较术前提高。眼部及颅内有关症状和体征全部消失或明显改善。结论 特征性眼部表现。超声、CT、选择性全脑数字减影血管造影(DSA)是诊断CCF的有效方法。血管内栓塞技术是目前CCF治疗的最理想方法。     

Arterio-venous fistula of cavernous sinus. A comparison of iatrogenic direct fistula with low flow dura shunt syndrome

PURPOSE: Comparison of symptoms of the low-flow dura shunt syndrome as a small arterial anomaly in the cavernous sinus with the direct, traumatic originated internal carotid artery fistula. MATERIAL AND METHODS: The clinical case report for two patients. The first case with a direct cavernous sinus fistula was diagnosed using angiography and the patient was treated with a detachable balloon catheter through the inferior petrousal sinus. The second case after the diagnosis was followed up with doppler sonography. RESULTS: The first case developed the direct cavernous sinus fistula after second thrombarteriotomy of the right internal carotid stenosis. The diagnosis, by typical clinical symptoms, was confirmed through the cavernous sinus angiogram with enlarged superior and inferior ophthalmic veins. The drainage was accomplished through the inferior petrousal sinus and the intercavernous sinus with accompanying signs of cortical drainage. All clinical symptoms, except for the abducens nerve palsy and the incomplete oculomotor nerve palsy, were reduced after neurosurgical occlusion of the fistula. The second case with the low-flow dura shunt syndrome was symptomatic by hypertension crisis and some spontaneous reduction was noticed. CONCLUSIONS: The iatrogenic direct cavernous sinus fistula is seldom but a very dangerous vital complication of the internal carotid arterial stenosis surgery and must be immediately closed through the endovascular embolisation therapy. The low-flow dura shunt syndrome may be in 50% occluded spontaneously.     

Management of nontraumatic vascular shunts involving the cavernous sinus

The authors managed 38 consecutive cases of nontraumatic vascular shunts involving the cavernous sinus. Selective angiography demonstrated 12 carotid cavernous fistulas (CCFs) and 26 dural arteriovenous shunts (DAVSs). Visual disability occurred from glaucoma, venous retinopathy, optic neuropathy, or diplopia. Ten patients with slow-flow shunts and minimal dysfunction were treated medically to lower intraocular pressure (IOP) and/or instructed in manual compression of the internal carotid artery, ipsilateral to the lesion, using the contralateral hand. Percutaneous intraarterial embolization using detachable balloons, isobutylcyanoacrylate, or polyvinyl alcohol particles was successful in 16/18 DAVSs and 9/10 CCFs. The neuro-ophthalmic signs resolved in these 25 cases. Complications occurred in five patients. These included a transient hemiparesis, twelfth nerve palsy, unilateral nasal field loss, a pseudoaneurysm causing a third-nerve paresis, and temporary cavernous sinus thrombosis. Conservative therapy in mild cases and embolization in cases with visual disability or progressive signs are warranted.     

栓塞治疗颈动脉海绵窦瘘的良好效果(英文)

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(IOP)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。