海绵窦硬脑膜动静脉瘘经静脉栓塞后三叉神经痛的缓解
Resolution of Trigeminal Neuralgia After Transvenous Embolization of a Cavernous Sinus Dural Arteriovenous Fistula.
作者信息
Fukutome Kenji, Nakagawa Ichiro, Park Hun Soo, Wada Takeshi, Motoyama Yasushi, Kichikawa Kimihiko, Nakase Hiroyuki
机构信息
Department of Neurosurgery, Nara Medical University, Nara, Japan.
Department of Neurosurgery, Nara Medical University, Nara, Japan.
出版信息
World Neurosurg. 2017 Feb;98:880.e5-880.e8. doi: 10.1016/j.wneu.2016.11.033. Epub 2016 Nov 17.
BACKGROUND
Trigeminal neuralgia (TN) resulting from a dural arteriovenous fistula (DAVF) are rare. A case of cavernous sinus dural arteriovenous fistula (CSDAVF) in a patient with TN that resolved immediately after transvenous embolization (TVE) is described.
CASE DESCRIPTION
A 75-year-old woman presented with continuous facial pain. On time-of-flight magnetic resonance angiography (MRA), a CSDAVF was suspected, and digital subtraction angiography (DSA) showed a CSDAVF. The TN completely resolved immediately after TVE, with no recurrence. Follow-up MRA showed complete obliteration of the fistula 13 months after TVE.
CONCLUSIONS
The pulsatile flow at the posteromedial part of the cavernous sinus might have compressed the upper aspect of the Gasserian ganglion, causing TN. Disappearance of pulsatile flow after TVE might result in complete resolution of TN.
背景
由硬脑膜动静脉瘘（DAVF）引起的三叉神经痛（TN）较为罕见。本文描述了一例患有TN的患者，其海绵窦硬脑膜动静脉瘘（CSDAVF）在经静脉栓塞术（TVE）后立即得到缓解。
病例描述
一名75岁女性出现持续性面部疼痛。在时间飞跃磁共振血管造影（MRA）检查中，怀疑存在CSDAVF，数字减影血管造影（DSA）显示为CSDAVF。TVE后TN立即完全缓解，且无复发。随访MRA显示TVE后13个月瘘管完全闭塞。
结论
海绵窦后内侧部分的搏动性血流可能压迫了半月神经节的上部，导致TN。TVE后搏动性血流消失可能导致TN完全缓解。
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