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Article: Carotid-cavernous sinus fistula presenting with contralateral intracerebral haemorrhage

TitleCarotid-cavernous sinus fistula presenting with contralateral intracerebral haemorrhage
Authors
KeywordsAngiography
Carotid artery diseases
Cavernous sinus
Cerebral hemorrhage
Stroke
Issue Date2012
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkjr.org
Citation
Hong Kong Journal of Radiology, 2012, v. 15 n. 3, p. 170-173 How to Cite?
AbstractCarotid-cavernous fistula is a well-established neurological disease that typically presents with proptosis, chemosis, ophthalmic bruit, and cranial nerve palsies. This report is of an atypical case of carotid-cavernous fistula that resulted in contralateral intracerebral haemorrhage. A 28-year-old woman presented with sudden headache and was found to have a right temporal intracerebral haemorrhage. She did not have ocular symptoms such as proptosis or chemosis. Angiographic studies revealed a left-sided direct-type (Barrow type A) carotid-cavernous fistula and no other significant findings. The left type A carotid-cavernous fistula was likely to have caused venous hypertension around the contralateral cerebral hemisphere and intracerebral haemorrhage by means of intercavernous venous cross-flow. This patient was also unusual in that the type A carotid-cavernous fistula, which rarely resolves without intervention, had disappeared spontaneously four days later. Carotid-cavernous fistula should be considered as a differential diagnosis in patients with spontaneous intracerebral haemorrhage, even in the absence of ocular symptoms. Investigations should include thorough angiographic studies of the contralateral cerebral vessels.
頸內動脈海綿竇瘻是一種已知的神經性疾病,症狀為眼球突出、球結膜水腫、眼雜音及顱神經麻 痺。本文報告一宗頸內動脈海綿竇瘻的非典型病例,病徵為對側腦內出血。一名28歲女性有突發性 頭痛,發現為右腦顳叶出血。病人未有出現如眼球突出或球結膜水腫,但其血管造影結果顯示左側 一直接型(即甲型Barrow)的頸內動脈海綿竇瘻。除此以外,並無其他嚴重疾病。此左邊甲型海綿 竇瘻造成竇內靜脈對流,引致對側大腦半球的靜脈高壓和腦內出血。這種甲型海綿竇瘻很少會自行 緩解。可是這名病人的頸內動脈海綿竇瘻在四日後自動緩解。如果病人出現自發性腦出血,縱使未 有眼部症狀,都應考慮頸內動脈海綿竇瘻鑒別診斷的可能性。應為病人的對側腦血管進行徹底的血 管造影檢查。
Persistent Identifierhttp://hdl.handle.net/10722/177393
ISSN
2015 SCImago Journal Rankings: 0.113

 

DC FieldValueLanguage
dc.contributor.authorLau, Ven_US
dc.contributor.authorLeung, Gen_US
dc.contributor.authorLee, Ren_US
dc.contributor.authorLui, WMen_US
dc.date.accessioned2012-12-18T05:06:53Z-
dc.date.available2012-12-18T05:06:53Z-
dc.date.issued2012en_US
dc.identifier.citationHong Kong Journal of Radiology, 2012, v. 15 n. 3, p. 170-173en_US
dc.identifier.issn2223-6619-
dc.identifier.urihttp://hdl.handle.net/10722/177393-
dc.description.abstractCarotid-cavernous fistula is a well-established neurological disease that typically presents with proptosis, chemosis, ophthalmic bruit, and cranial nerve palsies. This report is of an atypical case of carotid-cavernous fistula that resulted in contralateral intracerebral haemorrhage. A 28-year-old woman presented with sudden headache and was found to have a right temporal intracerebral haemorrhage. She did not have ocular symptoms such as proptosis or chemosis. Angiographic studies revealed a left-sided direct-type (Barrow type A) carotid-cavernous fistula and no other significant findings. The left type A carotid-cavernous fistula was likely to have caused venous hypertension around the contralateral cerebral hemisphere and intracerebral haemorrhage by means of intercavernous venous cross-flow. This patient was also unusual in that the type A carotid-cavernous fistula, which rarely resolves without intervention, had disappeared spontaneously four days later. Carotid-cavernous fistula should be considered as a differential diagnosis in patients with spontaneous intracerebral haemorrhage, even in the absence of ocular symptoms. Investigations should include thorough angiographic studies of the contralateral cerebral vessels.-
dc.description.abstract頸內動脈海綿竇瘻是一種已知的神經性疾病,症狀為眼球突出、球結膜水腫、眼雜音及顱神經麻 痺。本文報告一宗頸內動脈海綿竇瘻的非典型病例,病徵為對側腦內出血。一名28歲女性有突發性 頭痛,發現為右腦顳叶出血。病人未有出現如眼球突出或球結膜水腫,但其血管造影結果顯示左側 一直接型(即甲型Barrow)的頸內動脈海綿竇瘻。除此以外,並無其他嚴重疾病。此左邊甲型海綿 竇瘻造成竇內靜脈對流,引致對側大腦半球的靜脈高壓和腦內出血。這種甲型海綿竇瘻很少會自行 緩解。可是這名病人的頸內動脈海綿竇瘻在四日後自動緩解。如果病人出現自發性腦出血,縱使未 有眼部症狀,都應考慮頸內動脈海綿竇瘻鑒別診斷的可能性。應為病人的對側腦血管進行徹底的血 管造影檢查。-
dc.languageengen_US
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkjr.org-
dc.relation.ispartofHong Kong Journal of Radiologyen_US
dc.rightsHong Kong Journal of Radiology. Copyright © Hong Kong Academy of Medicine Press.-
dc.subjectAngiography-
dc.subjectCarotid artery diseases-
dc.subjectCavernous sinus-
dc.subjectCerebral hemorrhage-
dc.subjectStroke-
dc.titleCarotid-cavernous sinus fistula presenting with contralateral intracerebral haemorrhageen_US
dc.typeArticleen_US
dc.identifier.emailLeung, G: gilberto@hkucc.hku.hken_US
dc.identifier.emailLui, WM: mattlui@hku.hken_US
dc.identifier.authorityLeung, GKK=rp00522en_US
dc.identifier.hkuros212781en_US
dc.identifier.volume15en_US
dc.identifier.issue3-
dc.identifier.spage170en_US
dc.identifier.epage173en_US
dc.publisher.placeHong Kong-

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