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頸動脈海綿狀竇瘻管的診斷與預後

The Diagnosis and Prognosis of Carotid-Cavernous Sinus Fistula

摘要


榮民總醫院自民國67年1月至75年5月患有頸動脈海綿狀竇的病例共54例。其中外傷性36例,自發性18例。以頸動脈攝影檢查瘻管動脈來源為分類依據,典型瘻管44例,非典型瘻管10例。共有18例接受開刀治療,開刀方法包括淺顳動脈一中大腦動脈繞道手術及內頸動脈結紮或加上肌肉栓塞。另外有9例接受治療性放射線栓塞法,本篇比較過去手術方法及現代栓塞法在治療頸動脈海綿狀竇瘻管的臨床意義。

關鍵字

無資料

並列摘要


We collected 54 cases of carotid-cavernous sinus fistula from Jan. 1978 to May 1986. 36 cases were traumatic, 18 cases were spontaneous. Typical fistula were 44 cases, and atypical fistula were 10 cases according to the angiography. 18 cases received surgical operation (STAMCA bypass and ICA ligation: 6 cases; STA-MCA bypass and ICA ligation with muscle embolization: 12 cases.) Through 77% had clinical improvement, yet 55% had angiographic cure. The angiographic failure was due to collateral circulation from branches of external carotid aretry. Two cases were complicated with CRAO after operation. 9 cases received intraarterial or intravenous (superior ophthalmic vein) embolization which, resulted in 100% clinical improvement and 88% complete cure. The prognosis of carotidcarvernous sinus fistula was improved significantly. More secured and more effective therapy of carotid-cavernous sinus fistula is developing in our country.

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