Kim Kyoung-Tae, Kim Young-Baeg
Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, Korea.
J Korean Neurosurg Soc. 2010 Jan;47(1):48-50. doi: 10.3340/jkns.2010.47.1.48. Epub 2010 Jan 31.
Spontaneous intracranial hypotension is often idiopathic. We report on a patient presenting with symptomatic intracranial hypotension and pain radiating to the right leg caused by a transdural lumbar disc herniation. Magnetic resonance (MR) imaging of the brain revealed classic signs of intracranial hypotension, and an additional spinal MR confirmed a lumbar transdural herniated disc as the cause. The patient was treated with a partial hemilaminectomy and discectomy. We were able to find the source of cerebrospinal fluid leak, and packed it with epidural glue and gelfoam. Postoperatively, the patient's headache and log radiating pain resolved and there was no neurological deficit. Thus, in this case, lumbar disc herniation may have been a cause of spontaneous intracranial hypotension.
自发性颅内低压通常是特发性的。我们报告一例因经硬膜腰椎间盘突出症导致症状性颅内低压并伴有放射至右腿疼痛的患者。脑部磁共振成像显示出颅内低压的典型征象,另外脊柱磁共振成像证实腰椎经硬膜椎间盘突出为病因。患者接受了部分半椎板切除术和椎间盘切除术。我们找到了脑脊液漏的源头,并用硬膜外胶水和明胶海绵进行填充。术后,患者的头痛和腿部放射痛消失,且无神经功能缺损。因此,在该病例中,腰椎间盘突出症可能是自发性颅内低压的一个病因。