Kuramae Takumi, Inamasu Joji, Nakagawa Yu, Nakatsukasa Masashi
Department of Neurosurgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan.
Neurol Med Chir (Tokyo). 2011;51(7):518-21. doi: 10.2176/nmc.51.518.
A 28-year-old man presented with a case of spontaneous intracranial hypotension (SIH) manifesting as a bilateral chronic subdural hematoma (CSDH) without orthostatic headache. He developed life-threatening acute SDH as a complication of CSDH drainage. Neurosurgeons should be aware that SIH patients do not always present with orthostatic headache. Brain magnetic resonance imaging with gadolinium may be recommended for young adults with non-traumatic CSDH before drainage to exclude SIH, even if they do not present with orthostatic headache.
一名28岁男性患者出现自发性颅内低压（SIH），表现为双侧慢性硬膜下血肿（CSDH），无体位性头痛。他在CSDH引流术后出现了危及生命的急性硬膜下血肿（SDH），作为并发症。神经外科医生应意识到，SIH患者并不总是表现出体位性头痛。对于非创伤性CSDH的年轻成人患者，即使没有体位性头痛，在引流前也可能建议进行钆增强脑磁共振成像，以排除SIH。
