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硬脑膜动静脉畸形(DAVM)是一种少见的颅内血管疾病,约占颅内动静脉畸形的10～15％。本科收治一例孤立的完全性动眼神经麻痹,经DSA证实为海绵窦硬脑膜动静脉畸形。现报告如下: 男,62岁,复视伴右额部胀痛1O天入院。既往无高血压及糖尿病病史。查体:意识清楚,Bp18/10kPa。心肺听诊无异常发现。右完全性动眼神经麻痹(右瞳散大,光反射消失,右上睑下垂。右眼内、上、下方运动均受限,向前及向左注视复观著),余颅神经及锥体束征正常。主要实验室检查:血lgG2123mg/dl,CRP(十),血沉,血糖及脑脊液常规、生化、免疫球蛋白均正常。彩色双功能Doppler检查示颈部大血管内膜平整,未见斑块回声,血流无异常。经颅血管Doppler(TCD)检查示诸颅内动脉波形圆钝,频峰后移,频窗消失,左侧大脑中动脉,左侧颈内动脉血流速度高于右侧(分制为27cm/s,20cm/s)。冠状位CT扫描示右海绵窦略在于在侧。脯MRI无异常。入院后给予慢的松治疗。人院后第十三天DSA检查见颈外动脉分支(脑膜中动脉,咽斗动脉,及颌内动脉分支)向海绵窦部汇集,与颈内动脉、扩张增粗的基底静脉
Dural arteriovenous malformation (DAVM) is a rare intracranial vascular disease, accounting for about 10 to 15% of intracranial arteriovenous malformations. Undergraduate admitted to a case of isolated complete oculomotor nerve paralysis confirmed by DSA cavernous sinus dural arteriovenous malformations. Now report as follows: Male, 62 years old, diplopia with right forehead pain 1O days admission. No previous history of hypertension and diabetes. Examination: Consciousness, Bp18 / 10kPa. Cardiopulmonary auscultation no abnormal findings. Right complete oculomotor nerve paralysis (right pupil diffuse, light reflex disappears, right upper eyelid ptosis. Right eye, upper and lower exercise are limited, forward and left watching re-looking), the cranial nerves and the cone Beam sign normal. The main laboratory tests: blood lgG2123mg / dl, CRP (ten), erythrocyte sedimentation rate, blood glucose and cerebrospinal fluid routine, biochemical, immunoglobulin are normal. Color dual-function Doppler examination showed that the neck of large blood vessels intima formation, no plaque echo, no abnormal blood flow. Transcranial Doppler (TCD) showed intracranial arterial waveform blunt, frequency shift, frequency window disappear, the left middle cerebral artery, left internal carotid artery blood flow velocity is higher than the right side (27cm / s, 20 cm / s). Coronal CT scan showed the right cavernous sinus slightly on the side. No abnormalities in MRI Give slow pine treatment after admission. On the thirteenth day after hospitalization, DSA examination showed that the branches of the external carotid artery (middle meningeal artery, pharyngeal artery, and branch of the internal carotid artery) converged toward the cavernous sinus, and the internal carotid artery, dilated basilar veins