Spitze Arielle, Gersztenkorn David, Al-Zubidi Nagham, Yalamanchili Sushma, Diaz Orlando, Lee Andrew G
Department of Ophthalmology, Houston Methodist Hospital Houston, Texas USA.
Department of Ophthalmology, The University of Texas Medical Branch Galveston, Texas USA.
Neuroophthalmology. 2014 Jan 28;38(1):29-35. doi: 10.3109/01658107.2013.830628. eCollection 2014.
Intracranial dural arteriovenous fistulas (dAVFs) can produce a variety of symptoms depending on fistula location, size, and venous drainage. Although cavernous sinus fistulas (CCFs) classically present with symptoms of orbital venous congestion due to retrograde venous drainage into the superior ophthalmic vein (i.e. an arterialised "red eye") (Miller NR. 2007;23:1--15), dAVFs not localised to the cavernous sinus rarely present with a "red eye" and instead produce increased intracranial pressure, which can mimic idiopathic intracranial hypertension (IIH). The authors present a unique case of an intracranial dAVF with clinical features suggestive of both CCF and IIH. Clinicians should be aware of this possibility to avoid delayed diagnosis of the intracranial dAVF.
颅内硬脑膜动静脉瘘(dAVF)可根据瘘管位置、大小和静脉引流情况产生多种症状。虽然海绵窦瘘(CCF)典型地表现为由于眼上静脉逆行静脉引流导致的眶静脉充血症状(即动脉化的“红眼”)(米勒·NR。2007;23:1 - 15),但非海绵窦部位的dAVF很少出现“红眼”,而是产生颅内压升高,这可能酷似特发性颅内高压(IIH)。作者报告了一例独特的颅内dAVF病例,其临床特征提示既有CCF又有IIH。临床医生应意识到这种可能性,以避免颅内dAVF的延迟诊断。