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Neurological Surgery No Shinkei Geka Volume 19, Issue 8 （August 1991）

Neurological Surgery 脳神経外科 19巻8号（1991年8月発行）

Japanese English

症例

外傷5年後にクモ膜下出血にて発症した頸動脈海綿静脈洞瘻の1例 Carotid-cavernous Fistula Presenting Subarachnoid Hemorrhage 5 Years after Head Injury; Case report 菅野洋 ¹ , 猪森茂雄 ¹ , 千葉康洋 ¹ , 所和彦 ¹ , 安部裕之 ¹ , 中森昭敏 ² , 池田嘉宏 ³ , 吉田利之 ³ , 小田正治 ³ Hiroshi KANNO ¹ , Shigeo INOMORI ¹ , Yasuhiro CHIBA ¹ , Hiroyuki ABE ¹ , Kazuhiko TOKORO ¹ , Akitoshi NAKAMORI ² , Yoshihiro IKEDA ³ , Toshiyuki YOSHIDA ³ , Masaharu ODA ³ ¹神奈川県総合リハビリテーションセンター七沢リハビリテーション病院脳血管センター脳神経外科 ²神奈川県総合リハビリテーションセンター七沢リハビリテーション病院放射線科 ³国立横浜病院脳神経外科 ¹Department of Neurosurgery, Nanasawa Rehabilitation Hospital Cerebrovascular Center, Kanagawa Rehabilitation Center ²Department of Radiology, Nanasawa Rehabilitation Hospital Cerebrovascular Center, Kanagawa Rehabilitation Center ³Department of Neurosurgery, National Yokohama Hospital キーワード： Carotid-cavernous fistula , Subarachnoid hemorrage , Head injury , Detachable balloon Keyword: Carotid-cavernous fistula , Subarachnoid hemorrage , Head injury , Detachable balloon pp.767-771

発行日 1991年8月10日 Published Date 1991/8/10

DOI https://doi.org/10.11477/mf.1436900308

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Abstract 文献概要
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I．はじめに

　外傷性頸動脈海綿静脈洞瘻（以下CCFと略す）は受傷後早期に発症するのが大部分であるが，時に発症が遅れることがある^3）．また，CCFにクモ膜下出血を伴うことは少ない^4）．今回われわれは外傷5年後にクモ膜下出血にて発症したCCFを経験したので，発症が遅れた原因，およびクモ膜下出1飢をきたす機序について，若干の考察を加え，報告する．

Abstract

A case of traumatic carotid-cavernous fistula (CCF) which presented subarachnoid hemorrhage long after the injury is reported. A 24-year-old male was admitted to the National Yokohama Hospital with complaints of severe headache and nausea. CT scan and cerebral angiography showed subarachnoid hemorrhage due to ruptured CCF. His right visual acuity has disappeared after a traffic accident 5 years before, and he had hit his forehead again 3 years previously. He experienced severe headache twice for 2 weeks after his admission. He was transferred to Kanagawa Rehabilitation Center to be treated with intravascular surgery. Plain CT showed high density areas in the basal cisterns. CT af-ter contrast infusion disclosed a small enlarged high den-sity area in the right cavernous sinus, and showed an enhanced mass lesion in contact with the right ventro-lateral side of the midpons. The right internal carotid angiogram showed high flow CCF, fed only by the in-ternal carotid artery. It drained mainly into the basilar plexus, partially into the basal vein of Rosenthal and the inferior petrosal sinus. The CCF was found at the C4 portion of the right internal carotid artery. CT and the angiogram revealed a part of the CCF developing into a varix in the ventral side of the prepontine cistern.It ruptured and the patient developed subarachnoid hemorrhage 5 years after the head injury. The CCF was intravascularly embolized by a detachable balloon. Early treatment for CCF is necessary to prevent theoccurrence of subarachnoid hemorrhage if a part of the CCF develops into a varix.

It ruptured and the patient developed subarachnoidhemorrhage 5 years after the head injury. The CCFwas intravascularly embohzed by a detachable balloon.Early treatment for CCF is necessary to prevent theoccurrence of subarachlloid hemorrhage if a part of theCCF develops into a varix.