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目的:探讨一种有利于指导外伤性颈动脉海绵窦瘘(ＴＣＣＦ)诊断和治疗的分型。方法:６５例ＴＣＣＦ均行脑血管造影和血管内治疗,并将其临床表现、影像学和治疗结果进行分析、观察、分型。结果和结论:ＴＣＣＦ可分为３型(Ｉ型:单纯颈内动脉供血;Ⅱ型:颈内动脉颈外动脉均参与供血;Ⅲ型:双侧ＴＣＣＦ和２个亚型(ａ:向前、后、对侧的静脉引流;ｂ:伴有向上引流的混合性引流)。Ｉ型通过颈内动脉即可达到治愈;Ⅱ型需颈内、外动脉联合治疗或静脉入路;Ⅲ型需行双侧瘘口的分别治疗。ｂ型提示潜在的颅内出血,需尽早治疗。
Objective: To explore a type of diagnosis and treatment that is helpful to guide the traumatic carotid cavernous fistula (TCCF). Methods: All 65 TCCF patients underwent cerebral angiography and endovascular treatment. The clinical manifestations, imaging findings and treatment results were analyzed, observed and classified. RESULTS AND CONCLUSION: TCCF can be divided into three types (type I: simple internal carotid artery blood supply; type II: internal carotid artery external carotid artery are involved in blood supply; type III: bilateral TCCF and two subtypes (a: forward, After the contralateral venous drainage; b: with drainage diversion of mixed drainage) .I type through the internal carotid artery can be cured; type II required internal carotid artery and external artery treatment or intravenous approach; Bilateral fistula of the respective treatment.b type suggest potential intracranial hemorrhage, the need for early treatment.