Burns Judah, Scheinfeld Meir H
Division of Neuroradiology, Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY 10467, USA.
Emerg Radiol. 2013 Aug;20(4):291-7. doi: 10.1007/s10140-013-1111-2. Epub 2013 Feb 28.
Spinal canal procedures to withdraw fluid or introduce drugs are common minimally invasive techniques after which patients may experience new symptoms causing presentation to the emergency department. CT or MR imaging as part of the diagnostic workup may reveal expected or unexpected findings which may explain these symptoms. Small foci of gas within the spinal canal or intracranial compartment are common but are usually self-limited. Postlumbar puncture headache, presumed to be due to intracranial hypotension, may manifest on brain MR as dural thickening and low-lying cerebellar tonsils. Treatment with a blood patch is sometimes required for persistent symptoms. Spinal subarachnoid hemorrhage may be a devastating complication of dural puncture and may result in pain and paraplegia. In this review, technical details of these procedures are described and examples of common and uncommon postprocedure appearances on imaging are presented.
抽取脑脊液或注入药物的椎管内操作是常见的微创技术，术后患者可能会出现新症状并前往急诊科就诊。作为诊断检查一部分的CT或MR成像可能会发现预期或意外的结果，这些结果可能解释这些症状。椎管内或颅内腔隙内的小气泡灶很常见，但通常会自行缓解。腰穿后头痛，推测是由于颅内低压所致，在脑部MR上可能表现为硬脑膜增厚和小脑扁桃体下移。对于持续症状，有时需要进行血补丁治疗。脊髓蛛网膜下腔出血可能是硬膜穿刺的严重并发症，可能导致疼痛和截瘫。在本综述中，描述了这些操作的技术细节，并展示了成像上常见和不常见的术后表现示例。
