Bakshi R, Mechtler L L, Kamran S, Gosy E, Bates V E, Kinkel P R, Kinkel W R
University at Buffalo (SUNY) School of Medicine and Biomedical Sciences, USA.
Clin Imaging. 1999 Mar-Apr;23(2):73-6. doi: 10.1016/s0899-7071(99)00109-6.
Intracranial hypotension (IH) is a treatable cause of persistent headaches. Persistent cerebrospinal fluid (CSF) leak at a lumbar puncture (LP) site may cause IH. We present postcontrast MRI of a patient with post-lumbar-puncture headache (LPHA) showing abnormal, intense, diffuse, symmetric, contiguous dural-meningeal (pachymeningeal) enhancement of the supratentorial and infratentorial intracranial dura, including convexities, interhemispheric fissure, tentorium, and falx. MRI also showed abnormal dural venous sinus enhancement, a new finding in LPHA, suggesting compensatory venous expansion. Thus, IH and venodilatation may play a role in the development of LPHA.
颅内低压（IH）是持续性头痛的一个可治疗病因。腰椎穿刺（LP）部位持续的脑脊液（CSF）漏可能导致颅内低压。我们展示了一位腰椎穿刺后头痛（LPHA）患者的增强后MRI，其显示幕上和幕下颅内硬脑膜出现异常、强烈、弥漫、对称且连续的硬脑膜-脑脊膜（硬脑脊膜）强化，包括脑凸面、大脑镰下间隙、小脑幕和大脑镰。MRI还显示硬脑膜静脉窦强化异常，这是LPHA中的一个新发现，提示代偿性静脉扩张。因此，颅内低压和静脉扩张可能在LPHA的发生中起作用。
