Fujimaki Hiroya, Saito Nobuhito, Tosaka Masahiko, Tanaka Yukitaka, Horiguchi Keishi, Sasaki Tomio
Department of Neurosurgery, Gunma University School of Medicine, Maebashi, Gunma, Japan.
Surg Neurol. 2002 Sep-Oct;58(3-4):280-4; discussion 284-5. doi: 10.1016/s0090-3019(02)00801-7.
Precise determination of the spinal level of a cerebrospinal fluid leak is important in the diagnosis and treatment of spontaneous intracranial hypotension. The authors report two cases of SIH in which a cerebrospinal fluid leak was demonstrated by three-dimensional computed tomographic (3D-CT) myelography.
By overlaying 3D-CT images of contrast-enhanced CSF and the spine, the point of leakage was clearly depicted in the three-dimensional spinal structure, which assisted targeted epidural blood patch under the guidance of fluoroscopy. Although associated chronic subdural hematoma had to be treated by burr hole drainage, the patients' postural headaches subsided after treatment.
Clear CSF images in relation to vertebral bones are obtainable with 3D-CT myelography, rendering this modality very useful for the diagnosis and treatment of spontaneous intracranial hypotension.
准确确定脑脊液漏的脊髓节段对于自发性颅内低压的诊断和治疗至关重要。作者报告了两例通过三维计算机断层扫描（3D-CT）脊髓造影证实存在脑脊液漏的自发性颅内低压病例。
通过叠加增强脑脊液和脊柱的3D-CT图像，在三维脊柱结构中清晰地描绘出漏液点，这有助于在荧光透视引导下进行靶向硬膜外血贴治疗。尽管相关的慢性硬膜下血肿必须通过钻孔引流治疗，但患者的体位性头痛在治疗后缓解。
3D-CT脊髓造影可获得与椎骨相关的清晰脑脊液图像，使这种方法对自发性颅内低压的诊断和治疗非常有用。
