一例与硬脑膜动静脉瘘相关的眶内眼动脉动脉瘤破裂：经动脉和经静脉联合血管内治疗
A ruptured intraorbital ophthalmic artery aneurysm, associated with a dural arteriovenous fistula: combined transarterial and transvenous endovascular treatment.
作者信息
Kirsch M, Henkes H
机构信息
Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsklinikum, Greifswald, Germany.
出版信息
Minim Invasive Neurosurg. 2011 Jun;54(3):128-31. doi: 10.1055/s-0031-1277230. Epub 2011 Aug 23.
BACKGROUND
True aneurysms of the ophthalmic artery (OA) are extremely rare and most often arise at the origin of this artery. We present the endovascular management of a ruptured intraorbital OA aneurysm and of an associated dural arteriovenous fistula (dAVF).
PATIENT
A patient with a ruptured intraorbital ophthalmic artery aneurysm, associated with a dAVF with cortical drainage presented with acute visual loss and intra- and periorbital hematoma. The aneurysm was treated by endovascular coil occlusion. The dAVF was occluded by transvenous obliteration of the draining basal vein of Rosenthal. Both intraorbital ophthalmic artery aneurysms and their rupture are extremely rare.
CONCLUSION
Transvenous treatment of dAVFs is well feasible even with very far going catheterization, in this case to the origin of the basal vein of Rosenthal.
背景
眼动脉（OA）真性动脉瘤极为罕见，且大多起源于该动脉起始处。我们介绍了1例眶内眼动脉破裂性动脉瘤及相关硬脑膜动静脉瘘（dAVF）的血管内治疗情况。
患者
1例眶内眼动脉破裂性动脉瘤患者，合并伴有皮质引流的dAVF，表现为急性视力丧失及眶内和眶周血肿。该动脉瘤采用血管内弹簧圈栓塞治疗。dAVF通过经静脉闭塞Rosenthal基底静脉进行封堵。眶内眼动脉动脉瘤及其破裂均极为罕见。
结论
即使导管插入非常深入，在本例中至Rosenthal基底静脉起始处，经静脉治疗dAVF仍是可行的。
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