Palliative Treatment of Chronic Carotid-cavernous Fistula: A Case Report

慢性頸動脈海綿竇瘻管的保守療法：病例報告

10.29819/ANT.200309.0006

林高章(Kao-Chang Lin)；葉昭宏(Chow-Hong Yeh)；蔡宗佳(Tsung-Chia Tsai)

Carotid-cavernous Fistula ； Carotid Doppler ； Palliative Treatment ； Therapy

Acta Neurologica Taiwanica

12卷3期（2003 / 09 / 01）

149 - 153

英文

We presented a case of direct type carotid-cavernous fistula (CCF) without embolization or further operation after head injury in 1988. The patient received a conservative treatment for facial involuntary movement in the past years. Abducens nerve palsy and an ectasic vessel on the left eye were seen. Doppler studies showed stable hemodynamics during the follow-up. Magnetic resonance angiography demonstrated an increase of the outflow drain in the inferior petrous and sigmoid sinuses. From the literature, non-surgical management of direct type CCF is extremely rare and surgical therapies with a detachable balloon or remobilization are favored. However, conservative treatment may be also important in some patients. Collateralization and other drainage paths may play a role in ameliorating the symptoms of exophthalmos and chemosis. Doppler monitoring may be helpful in the long-term follow-up and decision making of surgical operation in the CCF.