Michels Kevin S, Ng John D, Falardeau Julie, Roberts Warren G, Petersen Bryan, Nesbit Gary M, Barnwell Stanley L
Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, OR 97239, USA.
Ophthalmic Plast Reconstr Surg. 2007 Nov-Dec;23(6):480-2. doi: 10.1097/IOP.0b013e318157da0b.
A 76-year-old woman presented with an acute onset of right periocular pain, diplopia, ocular injection, progressive proptosis, and periocular swelling. She had an unremarkable past medical history, and the erythrocyte sedimentation rate and complete blood count were normal. A carotid-cavernous sinus fistula was suspected, and an MRI demonstrated enlargement of the superior ophthalmic vein posterior to the globe and enlargement of the inferior ophthalmic vein throughout its entire course. Cerebral arteriography demonstrated a dural cavernous sinus fistula. The inferior ophthalmic vein was accessed via the inferonasal orbital space and was catheterized for delivery of multiple platinum coils to the cavernous sinus fistula. Follow-up venograms demonstrated occlusion of the fistula. At 2-month follow-up, there was a residual sixth nerve palsy and resolution of symptoms, including proptosis and periocular swelling.
一名76岁女性出现右眼周急性疼痛、复视、眼球充血、进行性眼球突出和眼周肿胀。她既往病史无异常，红细胞沉降率和全血细胞计数正常。怀疑为颈内动脉海绵窦瘘，MRI显示眼球后方的眼上静脉增粗，眼下静脉全程增粗。脑血管造影显示硬脑膜海绵窦瘘。经鼻下眶间隙进入眼下静脉，并将其插管，以便向海绵窦瘘输送多个铂金线圈。随访静脉造影显示瘘管闭塞。在2个月的随访中，仍有残余的第六脑神经麻痹，但症状包括眼球突出和眼周肿胀已消退。
