Department of Neurosurgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, Texas 77030, USA.
J Clin Neurosci. 2011 Apr;18(4):576-8. doi: 10.1016/j.jocn.2010.08.011.
Dural arteriovenous fistulas (DAVF) of the cavernous sinus most commonly present with ocular symptoms and can be observed or treated with endovascular approaches, surgery, or radiosurgery. Combined surgical-endovascular approaches have been used for fistulas that are not amenable to standard endovascular approaches. A 40-year-old man presented with ocular symptoms from a cavernous sinus DAVF. Multiple previous transarterial and transvenous embolization attempts had failed. The patient underwent craniotomy for surgical exposure and cannulation of an arterialized sylvian vein. Subsequently he underwent coiling and onyx embolization of the DAVF. The intervention resulted in effective obliteration of the fistula. If a cavernous sinus DAVF is refractory to treatment, surgical exposure and cannulation of a cortical draining vein can facilitate transvenous endovascular treatments.
海绵窦动静脉瘘（DAVF）最常表现为眼部症状，可通过血管内介入、手术或放射外科治疗进行观察或治疗。对于那些不能采用标准血管内介入治疗的瘘，联合手术-血管内介入治疗已被应用。一名 40 岁男性因海绵窦 DAVF 出现眼部症状就诊。多次经动脉和静脉内栓塞尝试均失败。患者行开颅术以暴露并插管动脉化的大脑外侧静脉。随后进行了 DAVF 的弹簧圈和 Onyx 栓塞。该介入治疗有效闭塞了瘘。如果海绵窦 DAVF 对治疗有抗性，皮质引流静脉的手术暴露和插管可以促进静脉内血管内治疗。
