颈动脉海绵窦瘘的眼部表现与血管内治疗

Occular manifestation and intravascular treatment of carotid cavernous fistula

目的:分析颈动脉海棉窦瘘的眼部临床特点,评价血管内治疗的效果。方法:回顾分析126例经全脑血管造影证实为颈动脉海绵窦瘘患者的病史、眼部表现、临床特点及进行的可脱性球囊栓塞治疗。结果:手术1次性栓塞成功者112例(88.9%),14例行2次栓塞。术后无并发症。98例视力较术前提高1～4行(国际标准视力表)。术后眼部淤血肿胀、眼球突出度均明显减轻或消失,眼球运动恢复正常,复视消失,视网膜出血吸收。眼部血管杂音全部消失,术后脑血管造影,瘘口均封闭。结论:对于颈动脉海绵窦瘘应及时治疗,尽快改善眼部淤血状态,以利于视功能恢复。血管内栓塞是目前治疗颈动脉海绵窦瘘最为理想的方法。

AIM: To evaluate the effect of intravascular occlusion on carotid cavernous fistula (CCF) by analyzing the ocular signs of CCF. · METHODS: A total of 126 cases with CCF demonstrated by cerebral angiography undertook intravascular occlusion treatment. Medical history, ocular features and clinical characteristics were analyzed before and after intravascular occlusion to assess the prognosis. · RESULTS: there were 112 cases treated successfully (88.89%) after the first occlusion, and the other 14 cases needed digital subtraction angiography. There was no operative complication or vascular murmur on eyes. Postoperative visual acuity of 98 cases improved 1-4 lines (Snellen's chart). Ocular signs such as exophthalmos, conjunctive swelling, diplopia and retinal hemorrhage decreased remarkably after surgery. · CONCLUSION: Early diagnosis and prompt treatment are necessary for CCF to improve visual acuity and eradicate clinical symptoms. Up to now intravascular occlusion is the most effective method to treat CCF. ·