眼症状を反対側に有する海綿洞動静脈瘻—特にその成因について

CAROTID-CAVERNOUS FISTULA WITH TYPICAL OCULAR SIGNS ON CONTRALATERAL SIDE: WITH SPECIAL REFERENCE TO THE MECHANISM OF THIS SYMPTOM

Ｉ．緒言

　同側に眼症状を呈する海綿洞動静脈瘻に関する報告はかなり多く見られ，本症は眼球突出，結膜のうつ血浮腫，頭蓋内血管雑音などにより特徴的とされている。しかし，動静脈瘻の反対側にのみ眼症状を呈する例についての報告は少なくあまり知られていない。1907年Pin—cus^13），ついでDandy　＆　Follis^1）が報告してより，このような例は私どもの蒐集しえたところでは現在までに16例が報告されたにすぎず，この成因についても剖検，脳血管写所見などより少しずつ明らかになっているものの，なお不明の点も少なくないようである。

1) A case of carotid-cavernous fistula with con-tralateral ocular signs without head injury was reported.

2) The patient was 57 year-old male, who gra-dually became aware of left-sided exophthalmos and intracranial noise. In his past history, there was high blood pressure and bronchial asthoma fromhis younger age.

3) The carotid-cavernous fistula on the right side and accompaning vein draining into the left internal cervical vein through left cavernous and petrosal sinus were demonstrated by cerebral angiography. There was an uneventful recovery after the ligation of both common and external carotid artery in the neck and intracranial internal carotid artery.

4) The reports on the carotid-cavernous fistula with contralateral ocular sign are very rare and this is the first case could be found in Japan.

5) The reported 17 cases including of the present case were discussed in detail especially on the mechanism of its occurence.