Spontaneous Carotid-Cavernous Fistula in a Patient With Ehlers-Danlos Syndrome Type IV
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概要
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A 30-year-old female complained of sudden onset of severe proptosis, chemosis, diplopia, and bruit. Right carotid angiography showed a high-flow direct carotid-cavernous fistula (CCF) draining into the engorged superior ophthalmic vein, inferior petrosal sinus, and pterygoid plexus. The patient experienced retroperitoneal bleeding from a ruptured right renal artery after undergoing cerebral angiography. We suspected Ehlers-Danlos syndrome (EDS) type IV, which was confirmed by showing cultured fibroblasts failed to secrete procollagen type III. Endovascular surgery cannot be considered the treatment method of choice in view of the fragility of the arteries and veins in patients with EDS type IV. We treated our patient with extracranial internal carotid artery ligation. Currently, there is no ideal treatment for CCF in patients with EDS type IV. Since CCF is rarely life-threatening, the investiga-tive approach and course of treatment must consider the associated vascular fragility.
- 日本脳神経外科学会の論文
- 2004-10-15
著者
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NAKAO Yasuaki
Department of Neurosurgery, Juntendo University Shizuoka Hospital
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ARAI Hajime
Department of Neurosurgery, Juntendo University School of Medicine
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MIYAJIMA Masakazu
Department of Neurosurgery, Juntendo University
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MITSUHASHI Takashi
Department of Neurosurgery, Juntendo University, Juntendo Urayasu Hospital
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HISHII Makoto
Department of Neurosurgery, Juntendo University School of Medicine
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Hishii Makoto
Department Of Neurosurgery Juntendo University School Of Medicine
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Arai Hajime
Department Of Hematology And Oncology University Of Fukui
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Nakao Yasuaki
Department Of Neurosurgery Juntendo University School Of Medicine
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SAITOH Rikizou
Department of Neurosurgery, Juntendo University School of Medicine
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Saitoh Rikizou
Department Of Neurosurgery Juntendo University School Of Medicine
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Miyajima Masakazu
Department Of Neurosurgery Juntendo University
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Mitsuhashi Takashi
Department Of Neurosurgery Juntendo University Juntendo Urayasu Hospital:(present Address)department
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Mitsuhashi Takashi
Department Of Neurosurgery Juntendo University School Of Medicine
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