Bachmann-Mennenga B, Philipps J, Haukamp F, Reinbold W D
Klinik für Anästhesiologie, Klinikum Minden.
Anaesthesist. 2004 Jan;53(1):45-52. doi: 10.1007/s00101-003-0601-0.
The spontaneous intracranial hypotension syndrome is a rare event but with increasing tendency. The clinical characteristics are comparable to those occurring after dural puncture and the most important clinical finding is the postural headache. The syndrome results from cerebrospinal fluid leakage but its etiology is still nearly unknown. The leaks are mainly located cervically or at the cervicothoracic junction. The syndrome may be associated with cranial subdural fluid build-up. Magnetic resonance imaging of the brain typically reveals diffuse pachymeningeal enhancement, frequently in association with displacement of the brain. Knowledge of this can be helpful to facilitate the diagnosis. Although conservative measures are often initially undertaken, placement of an epidural blood patch is the treatment of choice. Because of its similarity to postdural puncture headache, anaesthesiologists and pain therapists are increasingly involved in diagnosis and therapy. We report 2 patients with spontaneous intracranial hypotension. In addition to the cardinal feature of a postural headache, the patients suffered from subdural fluid build-up demonstrated by cranial magnetic resonance imaging.
自发性颅内低压综合征是一种罕见但有增加趋势的病症。其临床特征与硬膜穿刺后出现的特征相似，最重要的临床发现是体位性头痛。该综合征由脑脊液漏引起，但其病因仍几乎未知。漏液主要位于颈部或颈胸交界处。该综合征可能与颅硬膜下积液有关。脑部磁共振成像通常显示弥漫性硬脑膜强化，常伴有脑移位。了解这一点有助于促进诊断。虽然通常最初采取保守措施，但硬膜外血贴是首选治疗方法。由于其与硬膜穿刺后头痛相似，麻醉医生和疼痛治疗师越来越多地参与到诊断和治疗中。我们报告了2例自发性颅内低压患者。除了体位性头痛这一主要特征外，患者还出现了颅磁共振成像显示的硬膜下积液。
