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创伤性双侧颈内动脉海绵窦瘘情况下的血管痉挛及其对治疗的影响。

Vasospasm in the setting of traumatic bilateral carotid-cavernous fistulas and its effect on treatment.

作者信息

Ball Benjamin Z, Pelargos Panayiotis E, Christie Catherine, Golshani Kiarash

机构信息

Department of Neurological Surgery, University of California Irvine, Orange, California, USA.

出版信息

Surg Neurol Int. 2018 Jan 16;9:7. doi: 10.4103/sni.sni_190_17. eCollection 2018.

DOI:10.4103/sni.sni_190_17
PMID:29416904
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5791513/
Abstract

BACKGROUND

Direct, Type A, cavernous-carotid fistulas (CCFs) are predominantly caused by head trauma, especially when basilar skull fractures are present. Transarterial endovascular treatment of direct CCFs is the preferred method of treatment. Bilateral CCFs are estimated to be present in 1-2% of the cases. The treatment of bilateral CCFs is difficult often requiring a combination of endovascular and open surgical approaches.

CASE DESCRIPTION

We present a case of traumatic bilateral CCFs presenting with vasospasm of the anterior circulation seen on the initial angiogram on day 1 and our treatment paradigm.

CONCLUSION

This case illustrates the challenges in managing bilateral CCFs as well as the changes in collateral circulation because of cerebral vasospasm which affected our treatment paradigm.

摘要

背景

直接型 A 型海绵窦 - 颈动脉瘘（CCF）主要由头部外伤引起，尤其是存在颅底骨折时。经动脉血管内治疗直接型 CCF 是首选的治疗方法。据估计，双侧 CCF 在 1% - 2%的病例中出现。双侧 CCF 的治疗困难，通常需要血管内和开放手术方法相结合。

病例描述

我们报告一例创伤性双侧 CCF 病例，在第 1 天的初始血管造影中可见前循环血管痉挛，以及我们的治疗模式。

结论

本病例说明了双侧 CCF 管理中的挑战，以及由于脑血管痉挛导致的侧支循环变化，这影响了我们的治疗模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e67/5791513/2e84ff784917/SNI-9-7-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e67/5791513/48b27780128a/SNI-9-7-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e67/5791513/a4ab4092b0ce/SNI-9-7-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e67/5791513/ef30f70f0caa/SNI-9-7-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e67/5791513/4bf8b5a98c85/SNI-9-7-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e67/5791513/831a66b781e9/SNI-9-7-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e67/5791513/2e84ff784917/SNI-9-7-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e67/5791513/48b27780128a/SNI-9-7-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e67/5791513/a4ab4092b0ce/SNI-9-7-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e67/5791513/ef30f70f0caa/SNI-9-7-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e67/5791513/4bf8b5a98c85/SNI-9-7-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e67/5791513/831a66b781e9/SNI-9-7-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e67/5791513/2e84ff784917/SNI-9-7-g006.jpg

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本文引用的文献

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Cerebral vasospasm in traumatic brain injury.
创伤性脑损伤中的脑血管痉挛
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Endovascular trapping of direct carotid-cavernous fistula.血管内夹闭治疗直接颈动脉海绵窦瘘。
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Vasospasm in traumatic brain injury.创伤性脑损伤中的血管痉挛
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Combined transarterial, transvenous, and direct puncture of the cavernous sinus to cure a traumatic carotid cavernous fistula.联合经动脉、经静脉和直接穿刺海绵窦治疗外伤性颈动脉海绵窦瘘。
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