Clinical Characteristics and Imaging Diagnosis of the Traumatic Carotid Cavernous Fistula(TCCF) with Hemorrhage / 实用放射学杂志

ABSTRACT

Objective To explore the clinical and imaging characteristics of traumatic carotid cavernous fistula(TCCF) with hemorrhage.Methods There were thirteen cases of TCCF underwent car accidents combined with epistaxis or intracranial hemorrhage between 1990 and 2000.Their clinical symptoms,CT,MR,and digital substract angiogram(DSA) were retrospectively analysed.Results There were special clinical and imaging characteristics in TCCF.Small amount of epistaxis and isolateral loss of sight might be found in cases with epistaxis at early stage,but delayed fatal and massive epistaxis occured at various time after trauma.Cranial base fracture and pseudoaneurysm were special imaging signs.In the TCCF cases with intracranial hemorrhage,prominent and tortuose cortical drainage veins might be found.And pseudoaneurysm at posterio-lateral wall of cavernous sinus might be another special imaging sign.Conclusion Small amount of epistaxis at early stage,cranial base fracture,pseudoaneurysm,prominence and tortuosity of cortical veins are characteristic diagnostic references for TCCF with hemorrhage.Emergent DSA examination at early stage should be regarded as a key step for diagnosis and treatment.