Alén J F, Campollo J, Rivas J J, Lagares A, Pascual B, Jiménez-Roldán L, Lobato R D
Servicio de Neurocirugía, Hospital 12 de Octubre, Madrid.
Neurocirugia (Astur). 2008 Aug;19(4):338-42.
Indirect or dural carotid cavernous fistulas are abnormal connections between the cavernous sinus and meningeal branches of the external and/or internal carotid arteries. Most of them are idiopathic and occurs spontaneously. Symptoms vary from a tiny episcleral injection to a severe visual loss. Conservative therapy is recomended in cases with few symptoms and no leptomeningeal drainage, as spontaneous resolution is not infrequent. Whenever symptoms worsen, treatment of the fistula should be prescribed. Nowadays, transvenous endovascular treatment consisting of packing the cavernous sinus is the first choice. In most cases, cavernous sinus can be approached through the inferior petrosal sinus. However, sometimes that is not possible, and an approach directly through the superior ophthalmic vein could be necessary. We report a case of a patient with a dural carotid cavernous fistula treated with embolization of the cavernous sinus through the ophthalmic vein.
间接性或硬脑膜型颈内动脉海绵窦瘘是海绵窦与颈外和/或颈内动脉脑膜支之间的异常连接。其中大多数是特发性的，可自发发生。症状从轻微的巩膜表层充血到严重的视力丧失不等。对于症状轻微且无脑膜下引流的病例，建议采用保守治疗，因为自发缓解并不罕见。一旦症状恶化，就应进行瘘管治疗。如今，通过填塞海绵窦进行经静脉血管内治疗是首选方法。在大多数情况下，可通过岩下窦进入海绵窦。然而，有时无法做到这一点，可能需要直接通过眼上静脉进入。我们报告了一例通过眼静脉对海绵窦进行栓塞治疗硬脑膜型颈内动脉海绵窦瘘的患者。
