Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
J Neurosurg. 2010 Nov;113(5):955-60. doi: 10.3171/2010.5.JNS091405. Epub 2010 Jun 4.
Spontaneous intracranial hypotension (SIH) is a syndrome with serious neurological sequelae. As demonstrated by the following report, recurrent episodes of SIH can be difficult to diagnose when associated with other neurosurgical procedures, such as craniectomies. In this paper, the authors demonstrate SIH presenting as a subdural hematoma with recurrence of CSF leaks. Spontaneous intracranial hypotension was further complicated by paradoxical herniation following a craniectomy. Treatment of SIH necessitated multiple epidural blood patches for CSF leaks at different spinal levels and at different times. The efficacy of each epidural blood patch was confirmed with radionuclide imaging. Confirmation of effective blood patch placement may be useful for identifying patients at risk for a failed epidural blood patch or for patients whose neurological examination results have not fully improved.
自发性颅内低血压（SIH）是一种具有严重神经后遗症的综合征。如下文报告所示，当与其他神经外科手术（如去骨瓣减压术）相关时，SIH 的反复发作可能难以诊断。在本文中，作者展示了以硬脑膜下血肿和脑脊液漏复发为表现的 SIH。SIH 进一步复杂化，在去骨瓣减压术后出现矛盾性脑疝。治疗 SIH 需要多次硬膜外血贴治疗不同脊髓水平和不同时间的 CSF 漏。每个硬膜外血贴的疗效均通过放射性核素成像确认。确认有效的血贴放置可能有助于识别硬膜外血贴失败风险高的患者，或那些神经检查结果尚未完全改善的患者。
