PDF(Pubmed)
Abstract：
BACKGROUND: Spontaneous carotid cavernous fistula (CCF) is rare, and the expression of headache caused by it can be variable.
METHODS: A case of a man hospitalized for high-intensity hemicranial headache which was aggravated by lying down and relieved when standing or sitting. The pain was of a pulsating character, localized on the right, behind the eye, followed by nausea and vomiting. He gradually appeared with ophthalmoplegia, decreased visual acuity and epistaxis.
METHODS: Digital subtraction angiogram (DSA) showed a pseudoaneurysm arising from the internal carotid artery (ICA) that projected anteriorly and medially into the sphenoid sinus with occluded fistula.
METHODS: The pseudoaneurysm was successfully treated with covered stent.
RESULTS: The patient was then followed up clinically at the outpatient and seen in the outpatient clinic with no further episodes of nasal bleeding or new neurologic deficit. The vision loss and ophthalmoparesis were unchanged.
CONCLUSIONS: Hemicranial postural headache may be the first and characteristic sign of spontaneous CCF.
METHODS: A case of a man hospitalized for high-intensity hemicranial headache which was aggravated by lying down and relieved when standing or sitting. The pain was of a pulsating character, localized on the right, behind the eye, followed by nausea and vomiting. He gradually appeared with ophthalmoplegia, decreased visual acuity and epistaxis.
METHODS: Digital subtraction angiogram (DSA) showed a pseudoaneurysm arising from the internal carotid artery (ICA) that projected anteriorly and medially into the sphenoid sinus with occluded fistula.
METHODS: The pseudoaneurysm was successfully treated with covered stent.
RESULTS: The patient was then followed up clinically at the outpatient and seen in the outpatient clinic with no further episodes of nasal bleeding or new neurologic deficit. The vision loss and ophthalmoparesis were unchanged.
CONCLUSIONS: Hemicranial postural headache may be the first and characteristic sign of spontaneous CCF.
摘要：
背景：自发性颈动脉海绵窦瘘（CCF）很少见，由它引起的头痛的表达可能是可变的。
方法：1例因高强度半颅头痛住院的男子，躺下加重，站立或坐着时缓解。疼痛是一种脉动的特征，位于右边，眼睛后面,其次是恶心和呕吐。他逐渐出现眼肌麻痹，视力下降和鼻出血。
方法：数字减影血管造影（DSA）显示由颈内动脉（ICA）引起的假性动脉瘤，其向前和向内侧投射到蝶窦并闭塞瘘。
方法：用覆膜支架成功治疗假性动脉瘤。
结果：然后在门诊对患者进行了临床随访，并在门诊就诊，没有进一步的鼻出血或新的神经功能缺损。视力丧失和眼瘫没有变化。
结论：半颅体位性头痛可能是自发性CCF的首发和特征性体征。
方法：1例因高强度半颅头痛住院的男子，躺下加重，站立或坐着时缓解。疼痛是一种脉动的特征，位于右边，眼睛后面,其次是恶心和呕吐。他逐渐出现眼肌麻痹，视力下降和鼻出血。
方法：数字减影血管造影（DSA）显示由颈内动脉（ICA）引起的假性动脉瘤，其向前和向内侧投射到蝶窦并闭塞瘘。
方法：用覆膜支架成功治疗假性动脉瘤。
结果：然后在门诊对患者进行了临床随访，并在门诊就诊，没有进一步的鼻出血或新的神经功能缺损。视力丧失和眼瘫没有变化。
结论：半颅体位性头痛可能是自发性CCF的首发和特征性体征。
