首诊于眼科的颈动脉海绵窦瘘的临床分析和鉴别诊断

目的:分析首诊于眼科的颈动脉海绵窦瘘(carotid cavernous fistula,CCF)的临床特征和鉴别诊断,提高眼科医师对该病的诊断和治疗水平。方法:病例回顾性研究。回顾11例首诊于眼科的CCF的临床表现、诊断、鉴别诊断和治疗。结果:其中9例有不同程度的外伤史,眼部临床表现以搏动性突眼为特征,易误诊为眼眶炎性假瘤、眶内动脉瘤以及甲状腺相关性眼病等。经DSA确诊后血管内球囊栓塞治疗可获得较好疗效。结论:眼科医师应该加强对该病的认识,认真询问病史,结合特征性的临床表现以及脑血管造影检查可提高该病的诊断率。血管内栓塞治疗是CCF的首选,效果肯定。

Clinical analysis and differential diagnosis of carotid cavernous fistula first examined in ophthalmology

AIM: To analyze the clinical features and differential diagnosis of carotid cavernous fistula(CCF)first examined in ophthalmology department, and improve the diagnosis and treatment level among ophthalmologist.

METHODS:This was a retrospective case study. The details of clinical manifestations, diagnosis, differential diagnosis and treatment in 11 cases of CCF first examined in ophthalmology department were analyzed.

RESULTS:Nine patients had a history of trauma. The clinical ocular manifestation was mainly pulsatile proptosis, and the disease may be misdiagnosed as orbital inflammatory pseudotumor, orbital aneurysm, and thyroid associated ophthalmopathy. Obliteration of the fistula by intravascular balloon embolization was the current mainstay treatment after DSA examination.

CONCLUSION: With enhanced awareness of the disease, careful query of history, combined with the characteristic clinical manifestations, and utilizing cerebralangiography examination can improve the diagnosis rate. Endovascular embolization is a suitable treatment of the CCF with good prognosis.