From the Neurology Department, West China Hospital, Sichuan University, Chengdu, China.
Neurology. 2014 Apr 15;82(15):e134-5. doi: 10.1212/WNL.0000000000000319.
A 26-year-old woman developed headache, diplopia, and pulsatile tinnitus in 10 days. Neurologic examination revealed limitation of left eye movement, left dilated pupil with optic disc swelling and mild decreased vision, and a bruit over the left superior orbit. Her family history, laboratory data, and cerebral MRI showed normal findings. Cerebral CT angiography suggested left carotid-cavernous fistula (CCF). Follow-up angiography confirmed left CCF (figure 1). Nevertheless, multiple stenoses interspersed with aneurysmal dilation segments of carotid, vertebral, and renal arteries were found (figure 2). A diagnosis of fibromuscular dysplasia (FMD) was finally made. FMD is a rare cause of CCF.(1,2.)
一位 26 岁女性在 10 天内出现头痛、复视和搏动性耳鸣。神经系统检查显示左眼运动受限，左眼瞳孔扩大伴视盘肿胀和轻度视力下降，左侧眶上有杂音。家族史、实验室数据和脑部 MRI 均未见异常。脑部 CT 血管造影提示左侧颈动脉海绵窦瘘（CCF）。随访血管造影证实左侧 CCF（图 1）。然而，还发现颈动脉、椎动脉和肾动脉多处狭窄伴动脉瘤样扩张（图 2）。最终诊断为纤维肌发育不良（FMD）。FMD 是 CCF 的罕见病因。（1,2.）
