Waguri Noriko, Tomita M, Hayatsu K, Okamoto K, Shimoji K
Department of Anesthesiology, Niigata University Faculty of Medicine, Japan.
Acta Anaesthesiol Scand. 2002 Jul;46(6):747-50. doi: 10.1034/j.1399-6576.2002.460620.x.
Spontaneous intracranial hypotension is an uncommon disease caused by cerebrospinal fluid leakage. We reported a case of a 42-year-old male with postural headache who was diagnosed as having spontaneous intracranial hypotension. His headache did not completely improve by conservative therapies, so he underwent an autologous epidural blood patch. The site of cerebrospinal fluid restoration was identified at the level from the C2 to Th7 epidural space by 111In-DPTA cisternography and computed tomography coupled with myelography, and cervical EBP was performed. Because cerebrospinal fluid drops from the catheter, it is useful to identify the location of the catheter tip under contrast injection X-ray. Rapid and dramatic relief from the headache was obtained, and no serious complications occurred.
自发性颅内低压是一种由脑脊液漏引起的罕见疾病。我们报告了一例42岁男性患者,其患有体位性头痛,被诊断为自发性颅内低压。他的头痛经保守治疗后未完全改善,因此接受了自体硬膜外血贴治疗。通过铟-111二巯基丁二酸(111In-DPTA)脑池造影以及计算机断层扫描与脊髓造影相结合,在C2至Th7硬膜外间隙水平确定了脑脊液恢复的部位,并进行了颈椎硬膜外血贴治疗。由于脑脊液从导管滴出,在注入造影剂的X射线下确定导管尖端位置很有用。头痛迅速且显著缓解,未发生严重并发症。