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[脑脊液压力升高所致头痛]

[Headache from increased cerebrospinal fluid pressure].

作者信息

Göbel H, Göbel C, Heinze A

机构信息

Migräne- und Kopfschmerzzentrum, Neurologisch-verhaltensmedizinische Schmerzklinik Kiel, Heikendorfer Weg 9-27, 24149, Kiel, Deutschland.

出版信息

Schmerz. 2012 Jun;26(3):331-40; quiz 341. doi: 10.1007/s00482-012-1187-8.

Abstract

Increased cerebrospinal fluid (CSF) pressure is often accompanied by headache. The term idiopathic intracranial hypertension (pseudotumor cerebri) describes an increase in CSF pressure without a space-occupying intracranial lesion or hydrocephalus. After headaches, visual field defects are the second most common feature. Therapeutic measures include both drugs and surgical procedures. In high-pressure hydrocephalus, the volume of the CSF is increased, resulting either from increased production or reduced absorption. If an acquired or congenital obstruction of the ventricular system can be demonstrated, the term non-communicating hydrocephalus is used. In contrast, the CSF passage is blocked outside the ventricles in communicating hydrocephalus. Symptoms include diffuse headache worsening in the morning and with the Valsalva-like maneuver. Treatment is guided by etiology whenever possible; otherwise, drainage of CSF by ventriculostomy or shunt is necessary.

摘要

脑脊液(CSF)压力升高常伴有头痛。特发性颅内高压(假性脑瘤)一词描述的是脑脊液压力升高,而无颅内占位性病变或脑积水。头痛之后,视野缺损是第二常见的特征。治疗措施包括药物治疗和外科手术。在高压性脑积水中,脑脊液量增加,这要么是由于产生增加,要么是由于吸收减少所致。如果能证明存在获得性或先天性脑室系统梗阻,则使用非交通性脑积水这一术语。相比之下,在交通性脑积水中,脑脊液通道在脑室之外受阻。症状包括弥漫性头痛,在早晨及进行类似瓦尔萨尔瓦动作时加重。只要有可能,治疗就以病因学为指导;否则,通过脑室造瘘术或分流术引流脑脊液是必要的。

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