Chung T S, Lee J D, Suh J H, Kim D I, Park C Y
Department of Diagnostic Radiology and Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea.
J Nucl Med. 1993 Nov;34(11):1987-9.
Most symptoms and signs associated with a carotid cavernous fistula (CCF) are thought to be related to regurgitation of flow into cortical veins and to venous congestion. Arteriovenous shunting and secondary perfusion insufficiency is regarded as less important in causing symptoms. We describe a 27-yr-old male patient who had improvement of neurologic symptoms and signs after detachable balloon embolization of traumatic CCF. The pre- and postocclusion 99mTc-HMPAO brain SPECT scan showed improved cerebral blood flow after occlusion. The CCF had shown marked arteriovenous shunting without significant venous congestion on pre-occlusion cerebral angiogram. The postocclusion cerebral angiogram revealed complete occlusion of the CCF with increased blood flow in the ipsilateral middle cerebral artery distribution. These findings suggest that cerebral dysfunction may be related to perfusion insufficiency from the CCF. Brain SPECT scanning can assess the functional status of cerebral perfusion and may be a useful, noninvasive adjunct to angiography.
大多数与颈动脉海绵窦瘘（CCF）相关的症状和体征被认为与血流反流至皮质静脉及静脉充血有关。动静脉分流和继发性灌注不足在引起症状方面被认为不太重要。我们描述了一名27岁男性患者，其外伤性CCF经可脱性球囊栓塞后神经症状和体征有所改善。闭塞前后的99mTc-HMPAO脑SPECT扫描显示闭塞后脑血流改善。闭塞前脑血管造影显示CCF有明显的动静脉分流且无明显静脉充血。闭塞后脑血管造影显示CCF完全闭塞，同侧大脑中动脉分布区血流增加。这些发现提示脑功能障碍可能与CCF导致的灌注不足有关。脑SPECT扫描可评估脑灌注的功能状态，可能是血管造影的一种有用的非侵入性辅助检查。
