Chen Hsin-Hung, Huang Chun-I, Hseu Shu-Shya, Lirng Jiing-Feng
Department of Neurosurgery, The Neurological Institute, Taipei, Taiwan, R.O.C.
J Chin Med Assoc. 2008 Mar;71(3):147-51. doi: 10.1016/S1726-4901(08)70007-8.
Patients with both spontaneous intracranial hypotension (SIH) and subdural hematomas (SDH) are frequently undiagnosed. SIH may recur very often over a short interval or result in disastrous consequences if only the SDH is dealt with. We report a young adult with severe posterior nuchal pain; brain computed tomography showed bilateral SDH. He was discharged smoothly without any neurologic deficit after epidural blood patches were applied after proper and timely diagnosis. Patients with SIH complicated by SDH should not be overlooked. When patients complain of typical orthostatic headache without any history of trauma, SIH should be highly suspected. The therapeutic strategy for this type of SDH is different from those without SIH. We review the literature on the disease.
患有自发性颅内低压(SIH)和硬膜下血肿(SDH)的患者常常未被诊断出来。如果仅处理SDH,SIH可能在短时间内频繁复发或导致灾难性后果。我们报告一名患有严重后颈部疼痛的年轻成年人;脑部计算机断层扫描显示双侧SDH。经过恰当及时的诊断后应用硬膜外血贴,他顺利出院且无任何神经功能缺损。患有SIH并伴有SDH的患者不应被忽视。当患者主诉典型的直立性头痛且无任何外伤史时,应高度怀疑SIH。这种类型的SDH的治疗策略与不伴有SIH的SDH不同。我们回顾了关于该疾病的文献。