해면정맥동 경막동정맥루에 의한 고립성 동안신경마비: 증례 보고

Isolated Oculomotor Nerve Palsy Caused by Cavernous Sinus Dural Arteriovenous Fistula: Case Report

해면정맥동에 발생하는 경막동정맥루는 결막충혈, 안구돌출, 시력장애와 안구마비 등을 일으킬 수 있다. 하지만, 전형적인 안구증상 없는 고립성 동안신경마비로 발현되는 해면정맥동 경막동정맥루는 드물다. 저자들은 76세 여자 환자에서 발생한 고립성 동안신경마비의 원인인 해면정맥동 경막동정맥루의 경정맥치료의 경험을 보고하고자 한다.

Cavernous dural arteriovenous fistula (DAVF), which usually presents with conjunctival injection, proptosis, loss of visual acuity, and ophthalmoplegia, is a rare cause of ophthalmoplegia. Thus, it may be overlooked when the typical symptoms are lacking. There have been some cavernous DAVF case reports presenting with isolated oculomotor, abducens and trochlear nerve palsy. We report a patient presenting with isolated oculomotor palsy, caused by cavernous DAVF, which was treated by transvenous coil embolization. This case suggests that cavernous DAVF should be considered in the differential diagnosis of isolated oculomotor nerve palsy and for which case - selective angiography and embolization may be helpful in reaching a diagnosis and providing a guide for optimal treatment.