Settipani Natascia, Piccoli Tommaso, La Bella Vincenzo, Piccoli Federico
Institute of Neuropsychiatry, University of Palermo, Italy.
Funct Neurol. 2004 Jan-Mar;19(1):51-2.
Cerebrospinal fluid (CSF) leak at the lumbar puncture (LP) site may induce intracranial hypotension, a common cause of post-LP headache (LPH). We present the case of an 18-year-old man who developed a severe and continuous positional headache 24 hours after LP. CT scan and MRI showed abnormal, intense, dural venous sinus enhancement, indicating a compensatory venous expansion. The patient recovered fully within a fortnight. This report supports the hypothesis that venodilation may be involved in the pathogenesis of LPH. Brain MRI, to detect possible dural venous sinus abnormalities, should therefore be performed in patients with severe and prolonged LPH, as this may allow a prompt recognition and treatment of this disturbing condition.
腰椎穿刺（LP）部位的脑脊液（CSF）漏可能导致颅内低压，这是LP后头痛（LPH）的常见原因。我们报告一例18岁男性患者，在LP后24小时出现严重且持续的体位性头痛。CT扫描和MRI显示硬脑膜静脉窦强化异常、明显，提示静脉代偿性扩张。患者在两周内完全康复。本报告支持静脉扩张可能参与LPH发病机制的假说。因此，对于严重且持续性LPH患者，应进行脑部MRI检查以检测可能的硬脑膜静脉窦异常，因为这可能有助于及时识别和治疗这种令人困扰的病症。
