Muttaqin Z, Arita K, Uozumi T, Kuwabara S, Oki S, Ohba S, Kurisu K, Nakahara T, Kohno H, Satoh H
Department of Neurosurgery, Hiroshima University School of Medicine, Japan.
Surg Neurol. 1992 Sep;38(3):179-85. doi: 10.1016/0090-3019(92)90167-l.
Transcranial doppler sonography was performed transorbitally in five patients clinically diagnosed as unilateral carotid-cavernous fistula. Dural arteriovenous malformation related-shunts were detected in all the patients. In the normal eyes, the only doppler signals observed at an insonation depth of 45 to 55 mm were those of the ophthalmic artery. In the affected eyes, abnormal doppler signals with relatively higher flow velocity and lower resistance were observed. In three of the cases, these abnormal signals showed a flow directed anteriorly or away from the cavernous sinus, consistent with changes in the ophthalmic veins caused by the presence of the shunts. In two cases, however, the observed flows were directed posteriorly, the normal direction of these veins. The possible explanations for this discrepancy are discussed in relation with angiographic findings. The use of transcranial doppler might provide a better understanding about hemodynamic changes in carotid cavernous fistulas.
对5例临床诊断为单侧颈动脉海绵窦瘘的患者经眶进行经颅多普勒超声检查。所有患者均检测到硬脑膜动静脉畸形相关分流。在正常眼中，在45至55毫米的探测深度观察到的唯一多普勒信号是眼动脉的信号。在患眼中，观察到具有相对较高流速和较低阻力的异常多普勒信号。在其中3例中，这些异常信号显示血流向前或远离海绵窦，这与分流导致的眼静脉变化一致。然而，在2例中，观察到的血流是向后的，这是这些静脉的正常方向。结合血管造影结果讨论了这种差异的可能原因。经颅多普勒的应用可能有助于更好地了解颈动脉海绵窦瘘的血流动力学变化。
