Brightbill T C, Goodwin R S, Ford R G
Department of Radiology, Baptist Medical Center-Montclair, Birmingham, Alabama 35213, USA.
Headache. 2000 Apr;40(4):292-9. doi: 10.1046/j.1526-4610.2000.00043.x.
To correlate the pathophysiology of intracranial hypotension syndrome with abnormalities in the brain and spine found through magnetic resonance imaging.
In a series of 11 patients with intracranial hypotension syndrome, brain magnetic resonance scans were evaluated for the thickness, distribution, morphology, and pattern of meningeal enhancement coincident with subdural fluid collections and the descent of the brain toward the skull base. Spinal magnetic resonance studies were reviewed for extra-arachnoid fluid collections, meningeal enhancement, and distended epidural veins.
Diffuse, continuous dural-arachnoid enhancement was present in all patients with abnormal brain studies. The dura was thickest in patients with very low intracranial pressures. Subdural fluid collections and descent of the brain were seen in patients with the thickest meninges and were not present in the absence of meningeal enhancement. Extra-arachnoid or paraspinal fluid collections were found in all patients who had spinal magnetic resonance scans.
In the brain, diffuse dural-arachnoid enhancement is the most common imaging abnormality and is probably the earliest magnetic resonance manifestation of intracranial hypotension syndrome, while subdural fluid collections and descent of the brain are indicators of a more severe hypotensive state. Extra-arachnoid fluid collections are common spinal imaging abnormalities.
将颅内低压综合征的病理生理学与通过磁共振成像发现的脑和脊柱异常相关联。
在一系列11例颅内低压综合征患者中，对脑磁共振扫描进行评估，观察与硬膜下积液相关的脑膜强化的厚度、分布、形态和模式，以及脑向颅底的下沉情况。对脊柱磁共振研究进行回顾，观察蛛网膜下腔积液、脑膜强化和扩张的硬膜外静脉。
所有脑部检查异常的患者均出现弥漫性、连续性硬脑膜-蛛网膜强化。颅内压极低的患者硬脑膜最厚。脑膜最厚的患者出现硬膜下积液和脑下沉，而无脑膜强化时则不存在。所有进行脊柱磁共振扫描的患者均发现蛛网膜下腔或椎旁积液。
在脑部，弥漫性硬脑膜-蛛网膜强化是最常见的影像学异常，可能是颅内低压综合征最早的磁共振表现，而硬膜下积液和脑下沉是更严重低血压状态的指标。蛛网膜下腔积液是常见的脊柱影像学异常。
