Images in clinical medicine. Carotid-cavernous sinus fistula.
Images in clinical medicine. Carotid-cavernous sinus fistula.
复制标题
临床医学中的图像。
DOI：
10.1056/nejmicm1006035
复制
发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Zhang,Kang
中科院分区：
文献类型：
--
作者：
Korn,BobbyS;Zhang,Kang
55岁女性，长期高血压病史，1天眼眶周围不适，下腔化脓，左眼结膜注射（A组）。她报告有2年的发作性头痛和左耳搏动性耳鸣病史。左眼检查显示视力为20/60，瞳孔相对传入缺损，眼球突出（突出6毫米），眼压升高（48毫米汞柱）。右眼检查无明显异常。眼眶增强ct显示左侧眼上静脉扩张（B组，箭头），提示存在颈动脉海绵窦瘘。血管造影证实颈内动脉通过一个大瘘管与海绵窦相连（C组，黑色箭头）。眼上静脉扩张(B组，箭头；
A 55-year-old woman with a long history of hypertension presented to the hospital with a 1-day history of periorbital discomfort, inferior chemosis, and conjunctival injection of the left eye (Panel A). She reported having a 2-year history of episodic headache and pulsatile tinnitus in the left ear. Examination of the left eye revealed a visual acuity of 20/60, a relative afferent pupillary defect, exophthalmos (with 6 mm of protrusion), and an elevated intraocular pressure (48 mm Hg). Examination of the right eye was unremarkable. Contrastenhanced computed tomography of the orbit showed a dilated left superior ophthalmic vein (Panel B, arrow), suggesting the presence of a carotid–cavernous sinus fistula. Angiography confirmed that the internal carotid artery was connected to the cavernous sinus by a large fistula (Panel C, black arrow). Dilatation of the superior ophthalmic vein (Panel B, arrow;