Fernández E
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia 30322.
Headache. 1990 Feb;30(3):122-8. doi: 10.1111/j.1526-4610.1990.hed3003122.x.
Post-lumbar puncture headache (PLPHA) and spontaneous hypoliquorrheic headache are both associated with low spinal fluid pressure. A dull or throbbing occipital ache characteristically worsened by sitting or standing and eased by lying down is peculiar to both. Additional symptoms and signs may accompany the headache. In PLPHA the pain is triggered by leakage of cerebrospinal fluid through the dural rent, but the cause of the pain is probably due to intracranial arterial and venous dilatation. The same mechanism probably applies to spontaneous hypoliquorrheic headache in which the site of leakage is rarely found. The majority of cases subside without treatment over several days. Those that persist may be treated with epidural blood patch or saline infusion with good results. A simple, innocuous, yet underutilized form of treatment is caffeine sodium benzoate. This review will discuss the incidence, pathogenesis, prevention and treatment of these headaches.
腰穿后头痛（PLPHA）和自发性脑脊液减少性头痛均与脑脊液压力降低有关。两者的特征都是枕部钝痛或搏动性疼痛，坐立或站立时加重，躺下时缓解。头痛可能伴有其他症状和体征。在PLPHA中，疼痛是由脑脊液通过硬脑膜裂口漏出引发的，但疼痛的原因可能是颅内动静脉扩张。相同的机制可能适用于自发性脑脊液减少性头痛，其漏出部位很少能被发现。大多数病例在数天内未经治疗即可缓解。持续存在的病例可采用硬膜外血贴或生理盐水输注治疗，效果良好。咖啡因苯甲酸钠是一种简单、无害但未得到充分利用的治疗方式。本综述将讨论这些头痛的发病率、发病机制、预防和治疗。
