Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, No 6, Tiantan Xili, Chongwen, Beijing 100050, China.
Eur J Radiol. 2010 Aug;75(2):e129-34. doi: 10.1016/j.ejrad.2010.02.003. Epub 2010 Mar 2.
To report our findings concerning the laterocavernous sinus (LCS) drainage of dural fistulas, focusing our attention on the important implications in treatment of the LCS, which is one of the principal drainage pathways of the superficial middle cerebral vein (SMCV).
Consecutive 32 patients with dural fistulas treated endovascularly between 2005 and 2008 were reviewed. Seven patients had angiographic features such as dural fistulas draining with SMCV via LCS. Clinical records for these 7 patients were focused to determine their presenting symptoms, angiographic features, endovascular treatments, and clinical outcomes.
Over 3 years, 7 patients had 7 dural fistulas drained with SMCV via LCS were treated. Six-vessel angiography confirmed the presence of the dural fistulas. All fistulas were Cognard Type III featured by leptomeningeal veins drainage. One fistula involving the lesser sphenoid wing and 6 fistulas involving CS were supplied by external carotid artery branches with or without dural branches of the internal carotid artery. LCS was identified as a contiguous to SMCV drainage in these cases. One patient was treated with transvenous coil embolization alone, two with transvenous a combination of Onyx and coil embolization, and 4 with transarterial embolization. An angiographic obliteration and clinical cure was achieved in all patients. Complication was local hair loss due to X-ray radiation in one patient.
It is very important to diagnose the presence of LCS in dural fistulas during the diagnostic angiography. It is believed that the knowledge of LCS might be relevant for the understanding and treatment of dural fistulas involving the LCS.
报告我们对硬脑膜瘘管岩下窦（LCS）引流的发现，重点关注 LCS 在治疗中的重要意义，LCS 是大脑浅中静脉（SMCV）的主要引流途径之一。
回顾 2005 年至 2008 年间经血管内治疗的连续 32 例硬脑膜瘘患者。7 例患者具有硬脑膜瘘通过 LCS 与 SMCV 引流的血管造影特征。对这 7 例患者的临床记录进行了分析，以确定其临床表现、血管造影特征、血管内治疗和临床结果。
在 3 年多的时间里，有 7 例患者的 7 个硬脑膜瘘通过 LCS 与 SMCV 引流。六血管造影证实了硬脑膜瘘的存在。所有瘘管均为 Cognard III 型，特征为软脑膜静脉引流。一个瘘管涉及小蝶骨翼，6 个瘘管涉及 CS，由颈外动脉分支供应，或有或无颈内动脉硬脑膜分支。在这些病例中，LCS 被确定为与 SMCV 连续的引流。1 例患者仅接受经静脉线圈栓塞治疗，2 例患者接受经静脉 Onyx 和线圈栓塞联合治疗，4 例患者接受经动脉栓塞治疗。所有患者均实现了血管造影闭塞和临床治愈。1 例患者因 X 射线辐射导致局部脱发。
在诊断性血管造影中诊断硬脑膜瘘管中存在 LCS 非常重要。我们认为，对 LCS 的了解可能有助于理解和治疗涉及 LCS 的硬脑膜瘘管。
