Carotid-cavernous Fistula Associated with a Ruptured Persistent Primitive Trigeminal Artery Aneurysm: A Case Report and Review of Literature.

颈动脉海绵窦瘘伴原发性三叉神经动脉瘤破裂 1 例报告并文献复习.

• 发表时间: 2021
• 来源期刊: NMC Case Rep J
• DOI: 10.2176/nmccrj.cr.2021-0084
• PMID: 35079535
• 文章类型: Case Reports
• 作者列表: Shiomi K,Yamao Y,Ishii A,Kikuchi T,Okawa M,Yamada K,Yoshida K,Miyamoto S,Shiomi K,Yamao Y,Ishii A,Kikuchi T,Okawa M,Yamada K,Yoshida K,Miyamoto S

关键词: carotid-cavernous sinus fistula; coil embolization; parent artery occlusion; persistent primitive trigeminal artery; carotid-cavernous sinus fistula; coil embolization; parent artery occlusion; persistent primitive trigeminal artery

Abstract

Carotid-cavernous sinus fistula (CCF) caused by a ruptured aneurysm of the persistent primitive trigeminal artery (PPTA) is rarely reported. A 69-year-old woman presented with progressive ptosis and pulsating tinnitus. Vertebral angiography under flow control of the internal carotid artery revealed CCF associated with a ruptured PPTA-trunk aneurysm, and PPTA was divided into Saltzman type 2. Endovascular treatment was performed by coil embolization of the aneurysm and parent artery occlusion of the PPTA, preserving the basilar artery (BA) side of PPTA, without complications. In the case of ruptured aneurysms originating from the Saltzman type 2 PPTA trunk, parent artery occlusion of the PPTA might be a treatment option and preservation of the BA side of PPTA is necessary to avoid ischemic complication of pons.

摘要

很少报道由持续性原始三叉神经动脉（PPTA）的动脉瘤破裂引起的颈动脉海绵窦瘘（CCF）。一名69岁的女性出现进行性下垂和搏动性耳鸣。颈内动脉流量控制下的椎体血管造影显示CCF与破裂的PPTA主干动脉瘤相关，PPTA分为Saltzman2型。通过动脉瘤的线圈栓塞和PPTA的父动脉闭塞进行血管内治疗，保留PPTA的基底动脉（BA）侧，没有并发症。对于源自Saltzman2型PPTA干的破裂动脉瘤，PPTA的母体动脉闭塞可能是一种治疗选择，并且有必要保留PPTA的BA侧，以避免脑桥的缺血性并发症。