Hyun Seung Hyup, Lee Kyung-Han, Lee Su Jin, Cho Young Seok, Lee Eun Jeong, Choi Joon Young, Kim Byung-Tae
Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnamgu, Seoul, Republic of Korea.
Clin Neurol Neurosurg. 2008 Jul;110(7):657-61. doi: 10.1016/j.clineuro.2008.03.014. Epub 2008 May 23.
Spontaneous intracranial hypotension (SIH) is caused by spontaneous spinal cerebrospinal fluid (CSF) leaks. However, there is debate regarding clinical indication of radionuclide cisternography (RNC) for identification of the actual site of a CSF leak. We therefore investigated the potential value of RNC in SIH.
RNC was performed on 30 patients with SIH. Patients were managed with conservative management only or epidural blood patches (EBPs) according to clinical conditions and RNC findings.
RNC revealed direct signs of spinal CSF leaks in 80% of patients. Of this group, complete resolution of headache was obtained in 12 (71%) of 17 patients who received EBP vs. 1 (14%) of 7 patients treated with conservative management only (p=0.02). Complete headache relief with conservative management only was seen in one (14%) patient with direct signs of spinal CSF leaks compared to five (83%) patients without direct signs (p=0.03).
RNC is useful for diagnosis and better management planning of SIH.
自发性颅内低压（SIH）由自发性脊髓脑脊液（CSF）漏引起。然而，关于放射性核素脑池造影（RNC）用于识别CSF漏实际部位的临床指征存在争议。因此，我们研究了RNC在SIH中的潜在价值。
对30例SIH患者进行了RNC检查。根据临床情况和RNC检查结果，患者仅接受保守治疗或硬膜外血贴（EBP）治疗。
RNC显示80%的患者存在脊髓CSF漏的直接征象。在这组患者中，17例接受EBP治疗的患者中有12例（71%）头痛完全缓解，而仅接受保守治疗的7例患者中有1例（14%）头痛完全缓解（p=0.02）。仅接受保守治疗时，有脊髓CSF漏直接征象的患者中有1例（14%）头痛完全缓解，而无直接征象的患者中有5例（83%）头痛完全缓解（p=0.03）。
RNC对SIH的诊断和更好的治疗计划制定有用。
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