外伤性颈动脉海绵窦瘘致搏动性眼球突出24例的治疗体会

Treatments of pulsatile exophthalmos in 24 patients with traumatic carotid-cavernmous fistulas

目的探讨创伤性TCCF所致搏动性眼球突出最佳治疗方法。方法分别采用开颅行颈部颈内动脉结扎和颅内动脉结扎；开颅行海绵窦内铜丝堵塞瘘口术；用介入治疗方法行微弹簧圈TCCF栓塞术。结果颈内动脉，海绵窦瘘孤立手术2例治愈，但术后眼球回缩迟缓。铜丝血栓凝固术2例，术后出现严重头痛月余。微弹簧圈栓塞20例，搏动性突眼立即或逐渐消失。结论微弹簧圈栓塞是治疗TCCF致搏动性突眼的有效方法。

Objective To explore the best treatment of pulsatile exophthalmos in TCCF patients.Methods To open the cranium and ligate the internal carotid artery in the external cranium and internal cranium respectively;To open the cranium and put the copper wire into the sinus cavernosus to thrombosis the fistulas; Thrombosis the fistulas with microcoil by inter ventional treatment. Results Two patients were treated by trapping of carotid-cavernous fistula, but the rebounds of the eyeballs were very slow after operations. Two patients were treated by copper wire electro-throm bosis,but severe headache lasted for more than one month after treat ment.Twenty patients were treated by embloization of carotid-cavernous fistula by micoreoil, the fistulas disappeared at once or rapidly. Conclu sion Microcil treating pulsatile exorbitism in patients with traumatic carotid-cavernous fistulas is very effective.