[靶向硬膜外血贴：自发性颅内低压的有效治疗方法]
[Targeted epidural blood patch: an effective treatment for spontaneous intracranial hypotension].
作者信息
Wang Jin, Wang Li, He Fei-fang, Lu Pei-lin, Hu Xing-yue
机构信息
Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University, Hangzhou 310016, China.
出版信息
Zhonghua Yi Xue Za Zhi. 2009 Jun 2;89(21):1477-9.
OBJECTIVE
To report the authors' own experience in the treatment of spontaneous intracranial hypotension (SIH) with targeted epidural blood patch after locating the CSF leaks with CT myelography (CTM) and to discuss the mechanism and value of this method.
METHODS
Six patients with SIH (3 males and 3 females aged 33-66 years) were included. All patients met the diagnostic criteria of 2nd edition of International Classification of Headache Disorders (2004). CT myelography revealed the CSF leak sites in all 6 patients. Autologous blood mixed with Omnipaque (300 mg/ml) was injected after selective puncture at the leak site indicated by CTM.
RESULTS
All patients responded well to the treatment and achieved a complete resolution of symptoms. Nerve root irritation occurred in 2 patients. Three patients suffered from a temporary back pain.
CONCLUSION
With the location of leak sites by CTM, targeted epidural blood patch is an effective way to treat spontaneous intracranial hypotension.
目的
报告作者自身采用经CT脊髓造影（CTM）定位脑脊液漏后进行靶向硬膜外血贴治疗自发性颅内低压（SIH）的经验，并探讨该方法的机制和价值。
方法
纳入6例SIH患者（男3例，女3例，年龄33 - 66岁）。所有患者均符合《国际头痛疾病分类》第2版（2004年）的诊断标准。CT脊髓造影显示所有6例患者的脑脊液漏部位。在CTM所示漏口处进行选择性穿刺后，注入自体血与欧乃派克（300 mg/ml）的混合液。
结果
所有患者治疗反应良好，症状完全缓解。2例患者出现神经根刺激症状。3例患者出现暂时性背痛。
结论
通过CTM定位漏口部位后，靶向硬膜外血贴是治疗自发性颅内低压的有效方法。
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