摘要
目的:探讨一种有利于指导外伤性颈动脉海绵窦瘘(TCCF)诊断和治疗的分型。方法:65例TCCF均行脑血管造影和血管内治疗,并将其临床表现、影像学和治疗结果进行分析、观察、分型。结果和结论:TCCF可分为3型(I型:单纯颈内动脉供血;Ⅱ型:颈内动脉颈外动脉均参与供血;Ⅲ型:双侧TCCF和2个亚型(a:向前、后、对侧的静脉引流;b:伴有向上引流的混合性引流)。I型通过颈内动脉即可达到治愈;Ⅱ型需颈内、外动脉联合治疗或静脉入路;Ⅲ型需行双侧瘘口的分别治疗。b型提示潜在的颅内出血,需尽早治疗。
Aim:To investigate a new classification of angiography for traumatic carotid-cavernous fistula (TCCF) .Methods:The clinical files of 65 patients with TCCF confirmed by angiography and treated with intervention were reviewed retrospectively. The relationship among the angiographic features, clinical manifestations and therapeutic results were investigated. Results and Conclusion: According to angiographic characteristics TCCFs could be divided into 3 types and 2 subtypes. In typeⅠthe feeder comes from ICA only (direct fistula). In type Ⅱ the branches from ICA and/or ECA are suppliers (indirect fistula). The bilateral ICA direct fistulae compose type Ⅲ . Each type could further be divided into the following subtypes:subtype a (venous drainage anteriorly to ortib, posterior to petosal and opposite veins) and subtype b (subtype a with venous drainage to leptomeningeal veins) . Type I could be cured by ICA approach only. Both ICA and ECA approach or transvenous obliteration treated type Ⅱ . Type Ⅲ should be treated carefully by bilateral ICA routes respectively. TCCFs with subtype b suggest that the potential risk of intracranial hemorrhage and appropriated interventions should be done as soon as possible.
出处
《中国临床神经科学》
2001年第3期252-255,共4页
Chinese Journal of Clinical Neurosciences
关键词
外伤性颈动脉海绵窦瘘
脑血管造影
颈内动脉
颈外动脉
静脉引流
颅内出血
TCCF
traumatic carotid-carvemous fistula (TCCF)cerebral angiography internal carotid artery (ICA) external carotid artery (EIA)venous drainage intracranial hemorrhage