目的：探讨覆膜支架治疗外伤性颈内动脉海绵窦瘘（TCCF）的临床治疗经验。方法：11例TCCF经血管内介入治疗，1例外伤性颈内动脉海绵窦瘘患者复发，压迫颈总动脉无效，行球囊闭塞颈内动脉及瘘口。结果：术后杂音立即消失，数天后结膜水肿消退，造影见瘘口完全闭塞，10例TCCF患者颈内动脉保持通畅。1例患者颈内动脉闭塞。无操作所产生的并发症出现。结论：覆膜支架是处理TCCF的有效手段；瘘口再通可能与支架移位、贴壁不良有关。压迫颈总动脉对再通瘘口的治疗无效。
Objective To investigate the therapeutic effects of endovascular covered stent on vertebral dissecting aneurysm and carotid-cavernous fistula (CCF). Methods From March 2006 to May 2007, Jostent coronary stent grafts were used to treat 4 patients with vertebral dissecting aneurysm and 3 patients with CCF. The patients of vertebral dissecting aneurysmwere male and 37-57 years old, the lesion was located on the left vertebral artery in 3 patients and on the right vertebral artery in 1 patient, with the primary symptoms of sudden headache and vomiting; CT scan demonstrated subarachnoid hemorrhage; and the medical history varied from 2 days to 10 years. The patients of CCF were male and 35-51 years old, the lesion was located on the left carotid artery in 2 patients and on the right carotid artery in 1 patient, with the primary symptoms of headache, lateral exophthalmos, eyeball distending pain, conjunctive hyperemia and impaired eyesight; all 3 patients got head injury 2 days to 1 month before the appearance of symptoms and 1 of them had a history of severe nosebleed; and the medical history ranged from 1 week to 2 months. Results For the patients with vertebral dissecting aneurysm, complete obl iteration of aneurysms was achieved, the circulations of the vertebral artery, the adjacent posterior inferior cerebellar artery and the adjacent anterior inferior cerebellar artery were smooth, no compl ications relative to operation occurred, and no recurrence of symptoms and intracranial rehaemorrhagia were observed during the follow-up period of 8 months-2 years. For the patients with CCF, the fistula were completely obl iterated, the circulation of carotid artery was smooth, the exophthalmus and conjunctiva hyperemia were improved obviously 3 days after operation, the eyesight of patient was improved at different levels over the follow-up period of 1-3 months. Conclusion Endovascular covered stent is a new and useful tool for the treatment of vertebral dissecting aneurysm and CCF .
Objective To detect the clinical manifestations, diagnos is and treatment of painful ophthalmoplegia syndrome. Methods The data of onset, clinical m anifestations, laboratory examination, imaging and treatment from 12 patients with painful ophthalmoplegia, hospitalized from Mar, 2000 to Aug. 2005, were retro spectively analyzed. Results Multiple characters and extents of the headache were found in these 12 patients. The involved cranial nerves included the Ⅲ,Ⅳ, V1-2 and Ⅵ, especially the cranial nerve Ⅲ(83.3%). Several simultaneously in volved cranial nerves were frequently found (75%). Diseases which could cause hea dache along with ophthalmoplegia must be excluded before the diagnosis of the painful ophthalmoplegia syndrome was established. The examination of imaging was important for the diagnosis of painful ophthalmoplegia syndrome. Patients were sensitively responsive to cortico-steoid therapy. The cure rate was 75%. Conclusion The features of clinical manifestations, imaging results and the patients response to cortico-steoid therapy accorded with the etiology of nonspecific inflammation granuloma. Cortico-steoid therapy is effective after the definitude of the disease. (Chin J Ocul Fundus Dis, 2006,22:385-386)
目的:运用磁共振成像评价鼻咽癌海绵窦侵犯的影像学表现和侵犯途径。方法:回顾性分析经病理证实的140例鼻咽癌海绵窦侵犯病例的MRI图像及临床资料,观察海绵窦受侵的MRI表现和侵犯途径。结果:140例患者,受累海绵窦156侧,单途径侵犯共107侧,双途径侵犯共39侧,3条途径侵犯共8侧,4条途径侵犯共2侧。51侧(32.69％)为卵圆孔单途径受侵, 42侧(26.92％)破裂孔单途径受侵,多途径侵犯中卵圆孔、破裂孔作为共同途径共26侧(16.67％)。结论:MRI能较好的评价鼻咽癌海绵窦侵犯情况及其侵犯途径,卵圆孔侵犯是最常见的单一侵犯途径,其次为破裂孔;卵圆孔、破裂孔作为共同途径在多途径侵犯中最常见;经翼腭窝、圆孔途径侵犯海绵窦并不少见。