Department of Neurosurgery, Cedars-Sinai Medical Center, 127 South San Vicente Boulevard, A6600, Los Angeles, CA 90048, USA.
Curr Neurol Neurosci Rep. 2013 Jul;13(7):358. doi: 10.1007/s11910-013-0358-z.
Although for the vast majority of patients with spontaneous intracranial hypotension knowledge of the exact site of the underlying spinal CSF leak is not necessary, it is for patients with recalcitrant symptoms. Such patients may require directed treatments such as percutaneous fibrin glue injections or surgery. A variety of MRI techniques have been shown to be able to detect CSF leaks as well and sometimes better than the "gold standard" - CT-myelography. For unusually rapid CSF leaks - particularly those ventral to the spinal cord - digital subtraction myelography or dynamic CT-myelography are indicated. Some patients with spontaneous intracranial hypotension verified by intracranial MRI are never found to have a spinal CSF leak using current techniques.
虽然对于绝大多数自发性颅内低血压患者来说，了解潜在的脊髓脑脊液漏的确切部位并不是必需的，但对于那些症状顽固的患者来说则是必要的。这些患者可能需要接受有针对性的治疗，如经皮纤维蛋白胶注射或手术。各种 MRI 技术已被证明能够检测到脑脊液漏，有时甚至比“金标准”——CT 脊髓造影更好。对于异常快速的脑脊液漏——特别是那些位于脊髓腹侧的脑脊液漏——需要进行数字减影脊髓造影或动态 CT 脊髓造影。一些通过颅内 MRI 证实为自发性颅内低血压的患者，即使使用当前技术，也从未发现有脊髓脑脊液漏。
