血管内治療後に鼻閉が改善した海綿静脈洞硬膜動静脈瘻の1例

A case of cavernous sinus dural arteriovenous fistula with resolution of nasal congestion following endovascular therapy

海綿静脈洞硬膜動静脈瘻（cavernous sinus dural arteriovenous fistula：CSdAVF）はしばしば経験する疾患であり，結膜浮腫や眼球突出などの症状を呈したり，脳出血を起こして重症化することもある。今回我々は，結膜浮腫と眼球突出で発症したCSdAVFに対する血管内治療後に上顎洞の異常所見が改善した症例を経験したため報告する。

Cavernous sinus dural arteriovenous fistula（CSdAVF）is a condition commonly encountered in clinical practice and can present with a variety of symptoms, including chemosis, proptosis, and intracranial hemorrhage. We report a rare case of CSdAVF that demonstrated an unusual clinical course following endovascular treatment.

A 60-year-old-male was diagnosed with CSdAVF, presenting with proptosis and chemosis. Endovascular therapy was performed because cortical reflux was identified. Following treatment, the patient’s nasal congestion resolved. Moreover, chronic thickening of the nasal mucosa and long-standing fluid retention in the maxillary sinus, both of which had been present for several years, completely resolved on follow-up imaging.

Anatomically, venous drainage of the nasal mucosa communicates with the cavernous sinus. We hypothesize that successful treatment of the CSdAVF reduced venous pressure within the cavernous sinus, which subsequently improved nasal mucosal congestion and resulted in complete resolution of maxillary sinus fluid accumulation.