Liang Buqing, Moskalik Anzhela D, Taylor Maritza N, Waldau Ben
Department of Neurological Surgery, UC Davis Medical Center, Sacramento, California.
J Neurosurg Case Lessons. 2024 Aug 12;8(7). doi: 10.3171/CASE24183.
A 49-year-old woman with a history of hypertension presented to the emergency department with right eye redness, proptosis, orbital fullness, and blurry vision. She had initially been diagnosed with an orbital pseudotumor, and the symptoms worsened over a course of steroids. Computed tomography angiography raised concern for a carotid-cavernous fistula (CCF), which was subsequently confirmed by digital subtraction angiography.
She underwent fistula coil embolization via the internal maxillary artery and inferior ophthalmic vein (IOV). At the 2-month follow-up, she reported complete resolution of diplopia, orbital fullness, and proptosis. An ophthalmology examination revealed normal visual fields bilaterally.
CCF embolization is rarely performed through the IOV, with only 5 reported cases in the literature. This case demonstrates that the procedure can be easily performed if the anatomy is favorable over the superior ophthalmic vein, with the illustration of good cosmetic outcomes. https://thejns.org/doi/10.3171/CASE24183.
一名有高血压病史的49岁女性因右眼发红、眼球突出、眼眶饱满和视力模糊就诊于急诊科。她最初被诊断为眼眶假瘤，在使用类固醇治疗过程中症状加重。计算机断层血管造影引发了对颈动脉海绵窦瘘（CCF）的担忧，随后通过数字减影血管造影得以证实。
她通过上颌内动脉和眼 inferior ophthalmic vein（IOV）进行了瘘管弹簧圈栓塞术。在2个月的随访中，她报告复视、眼眶饱满和眼球突出完全消失。眼科检查显示双侧视野正常。
通过IOV进行CCF栓塞术很少见，文献中仅报道了5例。本病例表明，如果解剖结构优于眼上静脉，该手术可以轻松进行，且具有良好的美容效果。https://thejns.org/doi/10.3171/CASE24183 。 （注：原文中“inferior ophthalmic vein”直接保留英文未翻译完整，可能是特定医学术语，需确认准确中文表述）
