Brainstem Congestion Caused by Direct Carotid-Cavernous Fistula : Case Report
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概要
- 論文の詳細を見る
A 41-year-old woman presented with tinnitus in the left ear and headache, followed by diplopia and pain in the left cheek. Angiography showed a left high-flow direct carotid-cavernous fistula (CCF), causing steal of the blood flow from the internal carotid artery into the cavernous sinus. A few days later, she rapidly developed right hemiparesis, dysarthria, and ocular conjugate deviation to the right, and became somnolent. Angiography at that time revealed occlusion of the superior petrosal sinus, causing engorgement of the veins in the surrounding brainstem. The CCF was completely embolized with inter-locking detachable coils. Her consciousness disturbance and ophthalmoparesis dramatically improved within a few days, and the right hemiparesis and dysarthria gradually resolved. Magnetic resonance (MR) imaging after the treatment showed small pontine hemorrhage and perifocal edema but no ischemic lesions in the cerebral hemisphere. Re-evaluation of the MR imaging with gadolinium taken on admission demonstrated engorged veins in the brain stem parenchyma, which corresponded to the hemorrhagic lesion in the brainstem. Brainstem congestion caused by direct CCF is very rare, but it can be life-threatening. Good outcome can be expected if the CCF is completely occluded before congestive hemorrhage occurs.
- 日本脳神経外科学会の論文
- 2003-05-15
著者
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KANNO Hiroshi
Department of Neurosurgery, Yokohama City University Graduate School of Medicine
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FUJII Satoshi
Department of Neurosurgery, Yokohama City University School of Medicine
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YAMAMOTO Isao
Department of Neurosurgery, Yokohama City University School of Medicine
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Kubota Takeshi
Department Of Anesthesiology University Of Hirosaki School Of Medicine
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Kanno H
Department Of Neurosurgery Yokohama City University School Of Medicine
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MURATA Hidetoshi
Department of Neurosurgery, Yokohama City University School of Medicine
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MURAI Masao
Department of Neurosurgery, Yokohama City University School of Medicine
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Yamamoto Isao
Department Of Electronic Engineering Faculty Of Engineering Okayama University Of Science
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Yamamoto Isao
Department Of Neurosurgery Yokohama City University School Of Medicine
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Fujii Satoshi
Department Of Applied Chemistry Faculty Of Engineering Himeji Institute Of Technology
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Murai Masao
Department Of Neurosurgery Yokohama City University School Of Medicine
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Kitamura Hitoshi
Department Of Pathology Graduate School Of Medicine Yokohama City University
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Kanno Hiroshi
Department Of Electronics Kyushu University
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Yamamoto Isao
Department Of Urology Kochi Medical School
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Kubota Takeshi
Department Of Anesthesia Hachinohe Heiwa Hospital
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Kitamura Hitoshi
Division Of Anatomical And Surgical Pathology Yokohama City University School Of Medicine
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Kubota Takeshi
Department Of Neurosurgery Yokohama City University School Of Medicine
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Murata Hidetoshi
Department Of Neurosurgery Nishiarai Hospital
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Murata Hidetoshi
Department Of Neurosurgery Yokohama City University School Of Medicine
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Kanno H
Department Of Neurosurgery Yokohama City University Graduate School Of Medicine
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