Ferrante E, Citterio A, Savino A, Santalucia P
Departments of Neurosciences and Internal Medicine, Niguarda Cà Granda Hospital, Milan, Italy.
Cephalalgia. 2003 Sep;23(7):552-5. doi: 10.1046/j.1468-2982.2003.00587.x.
A 26-year-old man with Marfan's syndrome had postural headache. Brain MRI with gadolinium showed diffuse pachymeningeal enhancement. MRI myelography revealed bilateral multiple large meningeal diverticula at sacral nerve roots level. He was suspected to have spontaneous intracranial hypotension syndrome. Eight days later headache improved with bed rest and hydration. One month after the onset he was asymptomatic and 3 months later brain MRI showed no evidence of diffuse pachymeningeal enhancement. The 1-year follow-up revealed no neurological abnormalities. The intracranial hypotension syndrome likely resulted from a CSF leak from one of the meningeal diverticula. In conclusion patients with spinal meningeal diverticula (frequently seen in Marfan's syndrome) might be at increased risk of developing CSF leaks, possibly secondary to Valsalva maneuver or minor unrecognized trauma.
一名患有马凡综合征的26岁男性出现体位性头痛。钆增强脑MRI显示硬脑膜弥漫性强化。脊髓造影MRI显示双侧骶神经根水平有多个大的脑膜憩室。他被怀疑患有自发性颅内低压综合征。八天后，头痛通过卧床休息和补液得到改善。发病一个月后他无症状，三个月后脑MRI显示无硬脑膜弥漫性强化迹象。一年随访未发现神经异常。颅内低压综合征可能由其中一个脑膜憩室的脑脊液漏引起。总之，患有脊髓脑膜憩室（常见于马凡综合征）的患者发生脑脊液漏的风险可能增加，可能继发于瓦尔萨尔瓦动作或轻微未被识别的创伤。
