非典型表現之雙側創傷性頸動脈海綿竇瘻管：病例報告

Atypical presentation of bilateral traumatic carotid-cavernous fistulas: a case report

頸動脈海綿竇瘻管是頭部外傷後罕見的併發症，會引起相當嚴重的結果。我們報告了一位24歲男性在車禍兩星期之後出現了雙眼突出及眼球轉動異常的症狀，病患雙眼視力及眼壓正常，結膜沒有充血及水腫，經由電腦斷層血管攝影診斷為雙側頸動脈海綿竇瘻管，病患進行了兩次血管內栓塞治療後，眼部的症狀獲得改善。雙側外傷性頸動脈海綿竇瘻管是相當罕見的疾病，常見的症狀包括結膜充血水腫、眼壓上升、眼球突出、眼球轉動異常、視力下降，沒有及時治療的頸動脈海綿竇瘻管將會導致嚴重的後果，因此頭部外傷後出現以上任一症狀，都應該保持高度警覺，讓病患能早期獲得正確的診斷與適當的治療。

 

Carotid-cavernous fistula (CCF) is a rare sequela of head trauma, with poten-tially serious consequences. We report the case of a 24-year-old male patient who presented with bilateral CCFs two weeks after a traffic accident. He was found to have progressive proptosis, ophthalmoplegia without decreased vision, elevated in-traocular pressure or conjunctival chemosis. Subsequent computed tomographic an-giography confirmed a bilateral CCF. After the patient underwent two endovascular embolization procedures, the ocular symptoms were improved. Bilateral CCFs are extremely rare after craniofacial trauma. The most common signs of traumatic CCF include chemosis, elevated intraocular pressure, proptosis, impaired eye movement, and decreased vision. Untreated CCFs may result in severe consequences, therefore, a high index of suspicion must be maintained to establish a diagnosis and undergo an appropriate treatment.