自发性海绵窦区硬脑膜动静脉瘘的血管内治疗分析  

Endovascular Treatment of Spontaneous Cavernous Sinus Dural Arteriovenous Fistula(CS-DAVF)

作　　者：郑树法[1] 连葆强[1] 姚培森[1] 戴琳孙[1] 康德智[1] ZHENG Shufa;LIAN Baoqiang;YAO Peisen;DAI Linsun;KANG Dezhi(Department of Neurosurgery,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院神经外科,福州350005

出　　处：《福建医科大学学报》2018年第3期182-187,206,共7页Journal of Fujian Medical University

基　　金：福建省临床重点专科建设项目

摘　　要：目的总结以眼部为首发症状的海绵窦区硬脑膜动静脉瘘(CS-DAVF)的诊疗经验。方法回顾性分析30例接受血管内介入治疗的CS-DAVF患者的临床资料。结果 30例CS-DAVF中,眼球结膜充血20例(67%),其中5例(20%)伴有不同程度水肿;眼球突出16例(53%);颅神经功能障碍14例(47%);头痛11例(37%);头晕2例(7%);6例(20%)出现耳鸣或颅内杂音。治疗上经岩下窦途径12例,其中完全栓塞10例(83%),次全栓塞1例(8%),不完全栓塞1例(8%);经面静脉途径成功完全栓塞2例;经动脉途径进行栓塞16例,完全栓塞率9例(56%),次全栓塞6例(38%),重残1例(6%)。结论以球结膜充血为主要表现的眼科疾患,要注意排查CS-DAVF的可能性;岩下窦途径治疗CS-DAVF为首先方案。To analyze and summarize the endovascular treatment of spontaneous cavernous sinus dural arteriovenous fistula(CS-DAVF). Methods Retrospective analyses were conducted on the clinical data of 30 patients with CS-DAVF who underwent endovascular interventional treatment in our institution. Results Among all of the cases,20 cases(67%)were with ocular conjunctival congestion,5(20%)with different levels of edema. Eyeball protrusion accounted for 16(53%)cases,cranial nerve dysfunction accounted for 14(47%),headache accounted for 11(37%),dizziness accounted for 2(7%),and tinnitus or intracranial murmur accounted for 6(20%)cases. Twelve patients were embolized via the inferior petrosal sinus(IPS),complete embolization was performed in 10 cases(83%),subtotal embolization was performed in 1(8%),while incomplete embolism was performed in 1(8%). Two patients were completely embolized via the facial vein approach(FV)successfully. Transarterial embolization was performed in 16 patients,complete embolization was performed in 9(56%),subtotal embolization was performed in 6(38%),while 1(6%)was with severe disability. Conclusion Attention should be paid to the possibility of ocular conjunctival congestion caused by CS-DAVF. Embolization via inferior petrosal sinus is the first-choice treatment for most DAVFs.

关 键 词：动静脉瘘 海绵窦 硬膜/血液供给 栓塞 

分 类 号：R322.123[医药卫生—人体解剖和组织胚胎学] R322.81[医药卫生—基础医学]