Komiyama M, Nakajima H, Nishikawa M, Kan M
Department of Neurosurgery, Osaka City General Hospital, Osaka, Miyakojima, Japan.
AJNR Am J Neuroradiol. 1998 Oct;19(9):1641-4.
The purpose of this study was to ascertain the early angiographic features characteristic of traumatic carotid cavernous sinus fistulas (CCFs).
Eight patients with severe craniofacial injuries underwent emergency diagnostic and therapeutic angiography for intractable oronasal bleeding, starting on an average of 6.7 hours after trauma. Carotid angiograms and the clinical manifestation of traumatic CCFs were then reviewed retrospectively to determine characteristic angiographic features.
In four of the eight patients, no arteriovenous fistulas were found in the cavernous sinuses and symptomatic CCF did not occur during the follow-up period. In the remaining four patients, dural CCFs (Barrow type B) were observed, unilaterally in three patients and bilaterally in one. One of these four patients subsequently became symptomatic and required transarterial coil embolization.
Traumatic dural CCFs are frequently observed in the early stage of severe craniofacial trauma, if investigated. Although their spontaneous disappearance is known, some of these do become symptomatic and need treatment.
本研究的目的是确定创伤性颈动脉海绵窦瘘（CCF）的早期血管造影特征。
8例严重颅面损伤患者因难治性口鼻出血接受了急诊诊断性和治疗性血管造影，平均在创伤后6.7小时开始。然后回顾性分析颈动脉血管造影和创伤性CCF的临床表现，以确定特征性血管造影特征。
8例患者中有4例在海绵窦未发现动静脉瘘，随访期间未出现有症状的CCF。其余4例患者观察到硬脑膜CCF（Barrow B型），3例为单侧，1例为双侧。这4例患者中有1例随后出现症状，需要经动脉弹簧圈栓塞治疗。
严重颅面创伤早期若进行检查，常可观察到创伤性硬脑膜CCF。虽然已知其可自发消失，但其中一些确实会出现症状并需要治疗。
