自发性颅内低压：临床表现、影像学特征及治疗
Spontaneous intracranial hypotension: clinical presentation, imaging features and treatment.
作者信息
Park Eun-Soo, Kim Ealmaan
机构信息
Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
出版信息
J Korean Neurosurg Soc. 2009 Jan;45(1):1-4. doi: 10.3340/jkns.2009.45.1.1. Epub 2009 Jan 31.
OBJECTIVE
In the present study, the authors investigated the clinical and imaging features as well as the therapeutic outcomes of SIH (spontaneous intracranial hypotension) patients.
METHODS
A retrospective review of 12 SIH patients was carried out. The diagnostic work-up included lumbar tapping and measurement of CSF opening pressure, radioisotope cisternography, brain and spinal magnetic resonance imaging (MRI), and computed tomography (CT) myelography. Autologous epidural blood patching was performed in patients who did not respond to conservative therapies, including analgesics, steroids, hydration and rest.
RESULTS
Typical postural headache was found in 11 (91%) patients. Nine (75%) patients showed pachymeningeal enhancement on their initial T1-weighted MR images. The CSF opening pressure was less than 60 mmH(2)O in 9 of 11 patients. Autologous epidural blood patching was performed in 7 patients, and all of them showed good responses.
CONCLUSION
SIH can present with various clinical presentations and neuroimaging findings. Autologous epidural blood patching is thought to be the treatment of choice for patients with SIH.
目的
在本研究中，作者调查了自发性颅内低压（SIH）患者的临床和影像学特征以及治疗效果。
方法
对12例SIH患者进行回顾性研究。诊断检查包括腰椎穿刺及脑脊液初压测量、放射性核素脑池造影、脑和脊髓磁共振成像（MRI）以及计算机断层扫描（CT）脊髓造影。对包括镇痛药、类固醇、补液和休息在内的保守治疗无反应的患者进行自体硬膜外血贴补治疗。
结果
11例（91%）患者出现典型的体位性头痛。9例（75%）患者在初次T1加权磁共振图像上显示硬脑膜强化。11例患者中有9例脑脊液初压低于60 mmH₂O。7例患者接受了自体硬膜外血贴补治疗，所有患者均显示出良好的反应。
结论
SIH可表现为各种临床表现和神经影像学表现。自体硬膜外血贴补被认为是SIH患者的首选治疗方法。
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