Loumiotis I, Cloft H J, Lanzino G
Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
Interv Neuroradiol. 2011 Jun;17(2):208-11. doi: 10.1177/159101991101700211. Epub 2011 Jun 20.
The venous sinuses commonly found in the margins of the diaphragm and sella are venous interconnections between the bilateral cavernous dural sinuses and are termed intercavernous communications or intercavernous sinuses. They form a venous ring, a single "circular sinus" that extends throughout the skull base. We report the first case to our knowledge of an intercavernous sinus fistula. We emphasize the importance of thorough knowledge of lesion characteristics before considering any interventional procedure.An 84-year-old woman presented with alarming progressive orbital symptoms for one month affecting her left eye. A cerebral angiogram showed an intercavernous sinus fistula supplied by internal and external carotid arterial branches.Transvenous embolization through retrograde catheterization of the right inferior petrosal sinus allowed complete coil occlusion of the lesion. Cerebral angiography confirmed the absence of residual blood flow through the fistula.This report represents the first case of an intercavernous sinus dural arteriovenous fistula successfully treated with transvenous embolization. A detailed awareness of the regional anatomy is essential for treatment approach and favorable outcomes.
常见于膈和蝶鞍边缘的静脉窦是双侧海绵窦硬膜窦之间的静脉连接,被称为海绵间交通或海绵间窦。它们形成一个静脉环,一个贯穿颅底的单一“环状窦”。据我们所知,我们报告了首例海绵间窦瘘病例。我们强调在考虑任何介入手术之前,全面了解病变特征的重要性。一名84岁女性出现影响其左眼的令人担忧的进行性眼眶症状达一个月。脑血管造影显示由颈内动脉和颈外动脉分支供血的海绵间窦瘘。通过右岩下窦逆行插管进行经静脉栓塞,使病变完全被弹簧圈闭塞。脑血管造影证实瘘管内无残余血流。本报告代表了首例经静脉栓塞成功治疗的海绵间窦硬膜动静脉瘘病例。对局部解剖结构的详细了解对于治疗方法和良好预后至关重要。