<原著>頚動脈-海綿静脈洞瘻の臨床経験

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Five cases of carotid-cavernous fistulas are reviewed. Of these 5 fistulas, one was traumatic and 4 were spontaneous carotid-cavernous fistulas. In the traumatic case, the fistulas had been treated by ligation of the carotid artery 23 years before. Recurrence of symptoms and prominent development of collaterals were noted on admission. The patient was treated by trapping of the internal carotid artery with subsequent embolization of the external carotid artery. The clinical symptoms decreased immediately after operation. Of the spontaneous cases, two patients-received no therapy but the fistulas resolved spontaneously. The other two patients were treated by embolization of the external carotid artery ; one had clinical cure after 15 months, and the other had clinical improvement. In these patients, hemodynamics of the carotid-cavernous fistula was assessed by angiography and oculocerebrovasculometer. In the carotid-cavernous fistula, the blood flow in the cavernous sinus and draining venous system is much increased and then the oculo-vascular physiological alteration occurs. This alteration was observed indirectly by the oculocerebrovasculometry which showed raised intraocular pressure and ocular pulse amplitude. There was, however, apparent discrepancy between the clinical and the hemodynamic findings. The knowledge of hemodynamics was useful in the treatment and follow-up of the fistulas. Our experience suggests that the onset and the resolution of symptoms may be associated with the occurrence of thrombosis in the draining venous system.
近畿大学の論文
1987-06-25

<原著>頚動脈-海綿静脈洞瘻の臨床経験

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