Journal of Neuroendovascular Therapy
Online ISSN : 2186-2494
Print ISSN : 1882-4072
ISSN-L : 1882-4072
Case Reports
A Patient with a Cavernous Sinus Dural Arteriovenous Fistula in Whom Direct Puncture of the Superior Ophthalmic Vein Led to Rapidly Progressing Thrombosis and Postoperative Non-arteritic Ischemic Optic Neuropathy: Pathogenesis with Respect to a Drainage Route
Narihide ShinodaMasafumi MoriShogo TamuraKazuyoshi KorosueShigeru KoseHiroto ImaiTetsuya EnomotoRyouichi TominagaToshio MasahiraTatsuya MikiTomoya HiuraKen ShimodaKeiichiro SuwaJunichi ObataMutsuma AdachiYasushi MatsumotoEiji Kohmura
ジャーナル オープンアクセス

2019 年 13 巻 5 号 p. 221-227


Objective: We report a patient in whom direct puncture of the superior ophthalmic vein for a cavernous sinus dural arteriovenous fistula led to rapidly progressing thrombosis and postoperative non-arteritic ischemic optic neuropathy (NA-ION), and review the pathogenesis.

Case Presentation: A 74-year-old female. Detailed examination of diplopia and visual disorder suggested a cavernous sinus dural arteriovenous fistula. As approaching via a posterior route was difficult, transvenous embolization by direct puncture of the superior ophthalmic vein was performed. As drainage routes were aggregated around this vein, thrombosis of this vein occurred, inducing postoperative NA-ION through a rapid change in hemodynamics.

Conclusion: When performing direct puncture of the superior ophthalmic vein, puncture methods and heparinization should be considered after sufficiently investigating drainage routes.

© 2019 The Japanese Society for Neuroendovascular Therapy

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
前の記事 次の記事