Sarrafzadeh Asita S, Hopf Stephanie A, Gautschi Oliver P, Narata Ana-Paula, Schaller Karl
Division of Neurosurgery, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Medical Center, Geneva, Switzerland.
Department of Interventional and Diagnostic Neuroradiology, University Hospital of Geneva, Geneva, Switzerland.
Springerplus. 2014 Mar 21;3:153. doi: 10.1186/2193-1801-3-153. eCollection 2014.
Intracranial hypotension (IH) occurs typically spontaneous and is a potentially life-threatening condition characterized by symptoms varying from postural headache to coma, with classical magnetic resonance imaging (MRI) findings.
We report two cases of clinically relevant trauma-related IH and review of the literature. One patient with a cerebral trauma presented unilateral mydriasis and coma resolved by the Trendelenburg position (-20°) as urgency intervention. In the second patient, IH was caused by a lesion of the brachial plexus after a motor vehicle accident.
A history of mild or moderate trauma in association with prolonged postural or permanent headache may indicate IH. Posttraumatic IH is rare, nevertheless life-threatening in case of misdiagnosis. Intracranial hypotension in a trauma context is rarely described and difficult to diagnose. The change from tipical supine 30° to Trendelenburg position (0-20°) can be a life-saving manoeuver in these patients.
颅内低压（IH）通常为自发性发生，是一种潜在的危及生命的病症，其症状从体位性头痛到昏迷不等，并具有典型的磁共振成像（MRI）表现。
我们报告两例与创伤相关的具有临床相关性的颅内低压病例并进行文献回顾。一名脑外伤患者出现单侧瞳孔散大，通过头低脚高位（-20°）作为紧急干预措施后昏迷得以缓解。在第二例患者中，颅内低压由机动车事故后臂丛神经损伤引起。
伴有长时间体位性或持续性头痛的轻度或中度创伤史可能提示颅内低压。创伤后颅内低压很少见，但如果误诊则会危及生命。创伤情况下的颅内低压很少被描述且难以诊断。在这些患者中，从典型的仰卧30°变为头低脚高位（0 - 20°）可能是一种挽救生命的操作。
