临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2014年
7期
52-54
,共3页
刘景传%汤志伟%王崇谦%王进昆
劉景傳%湯誌偉%王崇謙%王進昆
류경전%탕지위%왕숭겸%왕진곤
动静脉瘘%颅内动静脉畸形%误诊%耳鸣%听觉丧失,感音神经性
動靜脈瘺%顱內動靜脈畸形%誤診%耳鳴%聽覺喪失,感音神經性
동정맥루%로내동정맥기형%오진%이명%은각상실,감음신경성
Arteriovenous fistula%Intracranial arteriovenous malformations%Misdiagnosis%Tinnitus%Hearing loss,sensorineural
目的:提高对硬脑膜动静脉瘘(dural arteriovenous fistula, DAVF)的认识及诊断水平。方法回顾性分析1例 DAVF 误诊病例资料。结果本例因右侧耳鸣1年余就诊,发病前曾发生交通事故,当时无外伤。1年前出现持续性右侧耳鸣,在当地医院耳鼻咽喉科误诊为感音性耳聋,予相应治疗症状无改善,后因症状加重,在当地医院经头颅螺旋 CT 动脉造影检查再次误诊为颈动静脉瘘。转我院后经彩色多普勒超声和数字减影血管造影检查确诊为DAVF。全身麻醉下行右侧 DAVF 瘘口栓塞术痊愈。随访2个月无复发。结论 DAVF 发病初期可以单纯耳鸣、耳聋为表现,临床及影像医生应提高对本病的认识,及早行相关影像学检查以减少误诊误治。
目的:提高對硬腦膜動靜脈瘺(dural arteriovenous fistula, DAVF)的認識及診斷水平。方法迴顧性分析1例 DAVF 誤診病例資料。結果本例因右側耳鳴1年餘就診,髮病前曾髮生交通事故,噹時無外傷。1年前齣現持續性右側耳鳴,在噹地醫院耳鼻嚥喉科誤診為感音性耳聾,予相應治療癥狀無改善,後因癥狀加重,在噹地醫院經頭顱螺鏇 CT 動脈造影檢查再次誤診為頸動靜脈瘺。轉我院後經綵色多普勒超聲和數字減影血管造影檢查確診為DAVF。全身痳醉下行右側 DAVF 瘺口栓塞術痊愈。隨訪2箇月無複髮。結論 DAVF 髮病初期可以單純耳鳴、耳聾為錶現,臨床及影像醫生應提高對本病的認識,及早行相關影像學檢查以減少誤診誤治。
목적:제고대경뇌막동정맥루(dural arteriovenous fistula, DAVF)적인식급진단수평。방법회고성분석1례 DAVF 오진병례자료。결과본례인우측이명1년여취진,발병전증발생교통사고,당시무외상。1년전출현지속성우측이명,재당지의원이비인후과오진위감음성이롱,여상응치료증상무개선,후인증상가중,재당지의원경두로라선 CT 동맥조영검사재차오진위경동정맥루。전아원후경채색다보륵초성화수자감영혈관조영검사학진위DAVF。전신마취하행우측 DAVF 루구전새술전유。수방2개월무복발。결론 DAVF 발병초기가이단순이명、이롱위표현,림상급영상의생응제고대본병적인식,급조행상관영상학검사이감소오진오치。
Objective To improve the awareness and diagnostic capability of dural arteriovenous fistula (DAVF). Methods Clinical data of one misdiagnosed patient with DAVF was retrospectively analyzed. Results The patient visited a doctor for the right tinnitus for more than one year, and the patient had a traffic accident in the earlier time, but the patient suffered no injury at that time. The patient had continuous right tinnitus one year ago, and was misdiagnosed as having senso-rineural hearing loss in other hospitals. The symptom was aggravating after corresponding treatment, and the patient was misdi-agnosed as having neck arteriovenous fistula after the head CT angiography (CTA) examination in the same hospital. DAVF was confirmed by color Doppler examination and digital subtraction angiography after the patient was transferred to our hospi-tal. The patient was cured by the right DAVF fistula embolization under general anaesthesia, and there was no recurrence within 2 months of follow-up. Conclusion DAVF may have simple tinnitus or hearing loss in the primary stage, so clinicians and radiological physicians should increase awareness of the disease and perform related iconography examinations in order to avoid misdiagnosis and mistreatment.