Hong Duc Pham, Thai Hoa Nguyen Thi, Quang Huy Huynh, Nguyen Anh Quoc
Radiology, Hanoi Medical University, Hanoi, VNM.
Oncology, Vietnam National Cancer Hospital, Hanoi, VNM.
Cureus. 2020 May 11;12(5):e8053. doi: 10.7759/cureus.8053.
The treatment of symptomatic cavernous sinus dural arteriovenous fistula, an unusually occluded cavernous sinus, is by a transvenous approach through the inferior petrosal sinus and superior ophthalmic vein. If these two modes of conventional transvenous access are not possible, surgical exposure and/or direct puncture access to the superior ophthalmic vein or cavernous sinus have been previously described. In a patient with progressive ophthalmological problems, the goal of treatment is to not only cure the ophthalmic symptoms but also to conserve or improve visual acuity, so treatment is needed as soon as possible. We report a 68-year-old woman suffering a Barrow type D cavernous sinus dural arteriovenous fistula. In this case, inadequate, inferior petrosal sinus embolization and lack of access for superior ophthalmic vein via a facial vein preceded percutaneous puncture under sonographic guidance of the superior ophthalmic vein. This permitted venous occlusion without complications and symptom-free for 11 months.
症状性海绵窦硬脑膜动静脉瘘（一种异常闭塞的海绵窦）的治疗方法是经岩下窦和眼上静脉的经静脉入路。如果这两种传统的经静脉入路方式不可行，之前已有关于手术暴露和/或直接穿刺眼上静脉或海绵窦的描述。对于患有进行性眼科问题的患者，治疗目标不仅是治愈眼科症状，还要保留或提高视力，因此需要尽早治疗。我们报告一名68岁女性患有巴罗D型海绵窦硬脑膜动静脉瘘。在该病例中，岩下窦栓塞不足，且经面静脉无法进入眼上静脉，随后在超声引导下经皮穿刺眼上静脉。这使得静脉闭塞且无并发症，患者在11个月内无症状。
