Tyree Tammy L, Porter Randall
Barrow Neurosurgical Associates, Phoenix, Arizona, USA.
J Am Acad Nurse Pract. 2012 May;24(5):286-9. doi: 10.1111/j.1745-7599.2012.00741.x.
To present an illustrative case study of a patient with spontaneous intracranial hypotension (SIH) and to increase awareness of this condition among nurse practitioners (NPs).
A literature search was conducted, and deidentified patient information forms the basis of this presentation. The authors' experience and appropriate images enhance the presentation of the case study.
SIH is a condition that typically occurs without a traumatic event, although it can be associated with minor trauma. It occurs when cerebrospinal fluid (CSF) leaks through a focal weakness in the dural sac or meningeal diverticula, resulting in CSF hypovolemia. Patients usually present with an orthostatic headache. The most common brain magnetic resonance imaging findings are diffuse pachymeningeal enhancement, descent of the cerebellar tonsils, and subdural fluid collections. Treatment options range from management of symptoms to surgical repair of the leak.
As NPs continue to provide care in a variety of settings, including emergency departments and urgent care areas, they must be familiar with the progression of symptoms that might indicate SIH and be prepared to make appropriate referrals to prevent iatrogenic morbidity.
介绍一例自发性颅内低压（SIH）患者的典型病例研究，以提高执业护士（NPs）对这种疾病的认识。
进行了文献检索，经过身份识别处理的患者信息构成了本病例报告的基础。作者的经验及相关图片丰富了病例研究的呈现。
SIH通常在无外伤事件的情况下发生，不过也可能与轻微外伤有关。当脑脊液（CSF）通过硬脊膜囊或脑膜憩室的局灶性薄弱处漏出时，就会导致脑脊液容量减少，进而引发SIH。患者通常表现为体位性头痛。脑部磁共振成像最常见的表现是硬脑膜弥漫性增厚强化、小脑扁桃体下移以及硬膜下积液。治疗方案从症状管理到漏口的手术修复不等。
随着NPs继续在包括急诊科和紧急护理区域在内的各种环境中提供护理服务，他们必须熟悉可能提示SIH的症状进展情况，并准备好进行适当的转诊，以预防医源性疾病的发生。
