关键词: 颈内动脉海绵窦瘘; 经颅多普勒; 介入治疗; 血液动力学

Abstract: Objective To observe hemodynamic changes by using Transcranial Doppler(TCD) in patients withtraumatic carotid-cavernous fistula(TCCF) before and after the interventional therapy(detachableballoon embolization).Methods We retrospectively analyzed(from Feb 2000 to Oct 2007) the TCD results of 18patients with TCCF before and after the operation and compared with the digital subtractionangiography(DSA) results.Results Of all the patients diagnosed TCCF through DSA before the operation, 15 patientsunderwent detachable balloon embolization and DSA confirmed a successful surgery; 2 patients hadto be changed to the affected internal carotid artery (ICA) occlusion and DSA images displayed theaffected ICA complete occlusion; one patient was forced to give up any operation for the vascularspasm. Before the treatment, the results showed a group of characteristic hemodynamic changes: (1)The higher velocity of blood flow and the lower pulsatility index (PI) in the extracranial segmentand/or the siphonic segment of ICA were showed in 17 patients and the spectra of the siphonicsegment of the affected ICA disordered. (2)The velocity of blood flow and PI were reduced in10 patients of the affected middle cerebral artery (MCA) and 16 patients of the anterior cerebralartery (ACA). (3)The velocity of blood flow was accelerated with normal spectra in 11 patientsof the affected posterior cerebral artery (PCA) and 14 patients of the contralateral ACA. (4) Theblood flow of the superior ophthalmic vein (SOV) was reversed and its abnormal frequencyspectra showed arterializational manifestation of the affected in 16 patients and of bilateral in 2patients. Seventeen patients were followed up with TCD at 1 week and 6 months. The abnormalhemodynamics of ICA and SOV in 15 patients were recovered or approached normally afterdetachable balloon embolization. The TCD in 2 patients after ICA occlusion showed the affectedICA complete occlusion (high velocity of blood flow of the affected PCA and the contralateralACA).Conclusion TCD provides a dynamic and real-time observation of the blood flow in theintracranial and extracranial blood vessels accurately, and also provides reliable hemodynamic datafor CCF in clinical diagnosis and treatment.

Key words: Carotid-cavernous fistulas; Transcranial Doppler; Interventional therapy; Hemodynamics