Oishi M, Nakahara K, Fukuuchi Y, Ebihara S, Gotoh F
Rev Neurol (Paris). 1979 Mar;135(3):245-50.
A 55-year-old female presented bilateral external ophthalmoplegias and a hypesthesia in the left face and then an intracranial bruit, bilateral conjunctival injections and bilateral chemosis. In her past history, there were right retinal hemorrhage, diabetes mellitus and hypertension but no cranial trauma. The arteriographical aspects were almost identical in both sides: selective external carotid arteriography revealed an opacification of the cavernous sinus through the ascending pharyngeal artery, the accessory meningeal artery and the middle meningeal artery, but the internal carotid arteries and the vertebral arteries did not participate in these fistulae. The association in our case of spontaneous external carotid-cavernous fistulae with intrahepatic gallbladder derived from a developmental arrest in the early stage of embryonic life suggests that spontaneous external carotid-cavernous fistula is derived from communications between extra-cranial vessels and the sinuses in the early stage of embryonic life.
一名55岁女性出现双侧眼球外展麻痹及左侧面部感觉减退,随后出现颅内杂音、双侧结膜充血和双侧结膜水肿。既往史有右眼视网膜出血、糖尿病和高血压,但无颅脑外伤史。两侧血管造影表现几乎相同:选择性颈外动脉造影显示通过咽升动脉、脑膜副动脉和脑膜中动脉使海绵窦显影,但颈内动脉和椎动脉未参与这些瘘管形成。我们病例中自发性颈外动脉-海绵窦瘘与胚胎早期发育停滞所致肝内胆囊并存,提示自发性颈外动脉-海绵窦瘘起源于胚胎早期颅外血管与海绵窦之间的交通。