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A Case of Cavernous Sinus Dural Arteriovenous Fistula Following Tolosa-Hunt Syndrome.

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dc.contributor.authorPark, A-
dc.contributor.authorKim, SW-
dc.contributor.authorChung, SA-
dc.date.accessioned2018-06-28T04:05:55Z-
dc.date.available2018-06-28T04:05:55Z-
dc.date.issued2016-
dc.identifier.issn0378-6471-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/15432-
dc.description.abstractPurpose: To report a case of cavernous sinus dural arteriovenous fistula following Tolosa-Hunt syndrome.
Case summary: A 64-year-old female with a history of hypertension, presented with blepharoptosis and periorbital pain in the right eye and diplopia. Her right pupil was dilated. She had right exotropia and right hypertropia with inability to elevate, depress, and adduct the right eye. Magnetic resonance imaging including angiography, revealed hyperintensities in the right cavernous sinus consistent with inflammation and no vascular abnormalities. Three days after oral corticosteroid therapy, the pain disappeared. A presumptive diagnosis was Tolosa-Hunt syndrome presenting as a form of complete oculomotor nerve palsy. Two months later, she experienced severe pain in the right periocular area, even though blepharoptosis was resolved and ocular motility was improved. A rapid response to high-dose intravenous corticosteroids was consistent with recurrence of Tolosa-Hunt syndrome. Three months later, she had normal ocular motility, but developed a conjunctival injection, pulsatile orbital bruits, and exophthalmos in the right eye. Cerebral angiography showed a cavernous sinus dural arteriovenous fistula. She received a transvenous coil embolization and her symptoms markedly improved over 2 months.
Conclusions: Tolosa-Hunt syndrome, a granulomatous inflammation in the cavernous sinus may be followed by cavernous sinus dural arteriovenous fistula and should be considered during follow-up.
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dc.description.abstract목적: 톨로사-헌트 증후군이었던 눈에서 발생한 경막동맥해면정맥굴샛길 증례를 경험하여 이를 보고하고자 한다.
증례요약: 고혈압이 있는 64세 여자 환자가 우안 주변의 통증, 우안 눈꺼풀처짐, 복시를 주소로 내원하였다. 우안 동공산대와 함께, 우안 외사시와 상사시, 그리고 심한 상전, 하전, 내전장애가 있었다. 뇌/뇌혈관자기공명영상에서 뇌혈관 이상은 없었으나 우측 해면정맥굴에 염증 소견이 있어서 경구 스테로이드로 치료하였고 3일 뒤 통증이 소실되어 완전 동안신경마비로 발현한 톨로사-헌트 증후군으로 생각되었다. 2개월 뒤 우안 눈꺼풀처짐은 소실되고 안구운동장애도 호전되었으나, 심한 우안 주변 통증이 다시 발생하였다. 톨로사-헌트 증후군의 재발로 생각되어 고용량 스테로이드 주사치료를 시행하였고, 빠른 호전을 보였다. 3개월 뒤 안구운동장애도 소실되었으나, 우안 결막충혈, 박동성 잡음, 안구돌출이 있어 시행한 뇌혈관조영술에서 우측 경막동맥해면정맥굴샛길이 확인되었다. 경정맥 코일 색전술 2개월 후 증상은 소실되었다.
결론: 해면정맥굴에 발생하는 육아종성 염증질환인 톨로사-헌트 증후군에서 경막동맥해면정맥굴샛길이 뒤이어 발생할 수 있으므로 경과관찰 시 주의해야 한다.
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dc.language.isoko-
dc.titleA Case of Cavernous Sinus Dural Arteriovenous Fistula Following Tolosa-Hunt Syndrome.-
dc.title.alternative톨로사-헌트 증후군에서 속발한 경막동맥해면정맥굴샛길 1예-
dc.typeArticle-
dc.subject.keywordCavernous sinus-
dc.subject.keywordDural arteriovenous fistula-
dc.subject.keywordTolosa-Hunt syndrome-
dc.contributor.affiliatedAuthor정, 승아-
dc.type.localJournal Papers-
dc.identifier.doi10.3341/jkos.2016.57.6.977-
dc.citation.titleJournal of the Korean ophthalmological society-
dc.citation.volume57-
dc.citation.number6-
dc.citation.date2016-
dc.citation.startPage977-
dc.citation.endPage982-
dc.identifier.bibliographicCitationJournal of the Korean ophthalmological society, 57(6). : 977-982, 2016-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn2092-9374-
dc.relation.journalidJ003786471-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Ophthalmology
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