Grant R, Condon B, Hart I, Teasdale G M
University Department of Neurosurgery, Southern General Hospital, Glasgow, UK.
J Neurol Neurosurg Psychiatry. 1991 May;54(5):440-2. doi: 10.1136/jnnp.54.5.440.
Post-lumbar puncture (LP) headache may be due to "low CSF pressure", leading to stretching of pain sensitive intracranial structures. The low intracranial pressure is secondary to net loss of intracranial CSF. It has, however, not been possible to measure intracranial CSF volume accurately during life until recently. Intracranial CSF volume can now be measured non-invasively by a MRI technique. The changes in intracranial CSF volume were studied in 20 patients who had LP. Total intracranial CSF volume was reduced in 19 of the 20 patients 24 hours after LP (range -1.8 mls to -158.6 mls). Most of the CSF was lost from the cortical sulci. Very large reductions in intracranial CSF volume were frequently related to post-LP headache but some patients developed headache with relatively little alteration in the intracranial CSF volume. There was not a measurable change in position of the intracranial structures following LP.
腰椎穿刺后头痛可能是由于“脑脊液压力过低”，导致颅内对疼痛敏感的结构被牵拉。颅内压降低是颅内脑脊液净丢失的继发结果。然而，直到最近才能够在患者活着的时候准确测量颅内脑脊液容量。现在可以通过磁共振成像（MRI）技术对颅内脑脊液容量进行无创测量。对20例接受腰椎穿刺的患者的颅内脑脊液容量变化进行了研究。20例患者中有19例在腰椎穿刺后24小时颅内脑脊液总体积减少（范围为-1.8毫升至-158.6毫升）。大部分脑脊液从皮质沟回中丢失。颅内脑脊液容量的大幅减少通常与腰椎穿刺后头痛有关，但一些患者在颅内脑脊液容量变化相对较小时也出现了头痛。腰椎穿刺后颅内结构的位置没有可测量的变化。
