Wang Jin, Zhang Dan, Gong Xiangyang, Ding Meiping
Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University, Hangzhou, Zhejiang 310016, China.
Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University, Hangzhou, Zhejiang 310016, China.
Chin Med J (Engl). 2014;127(11):2063-6.
Subdural hematoma (SDH) is a common complication of spontaneous intracranial hypotension (SIH). To date, the management of SDH caused by SIH remains controversial. In this paper, we reviewed the clinical course of SDH in patients with SIH, and discuss the underlying mechanism and attributing factors for rapid resolution of subdural hematomas after epidural blood patch (EBP) surgery.
We retrospectively reviewed a cohort of seventy-eight SIH patients diagnosed and treated with targeted EBP in our neurology center. Patients who received early CT/MRI follow-up after EBP operation were included.
A series of four cases of SIH complicated with SDHs were evaluated. Early follow-up neuroimages of these patients revealed that SDHs could be partially or totally absorbed just two to four days after targeted epidural blood patch treatment.
Targeted epidural blood patch can result in rapid hematoma regression and good recovery in some patients with a combination of SDH and SIH.
硬膜下血肿（SDH）是自发性颅内低压（SIH）的常见并发症。迄今为止，SIH所致SDH的治疗仍存在争议。本文回顾了SIH患者SDH的临床病程，并探讨了硬膜外血贴（EBP）手术后硬膜下血肿快速消退的潜在机制及相关因素。
我们回顾性分析了在我院神经科中心诊断并接受靶向EBP治疗的78例SIH患者队列。纳入EBP术后接受早期CT/MRI随访的患者。
评估了一系列4例合并SDH的SIH患者。这些患者的早期随访神经影像显示，靶向硬膜外血贴治疗后仅2至4天，SDH即可部分或完全吸收。
对于部分合并SDH和SIH的患者，靶向硬膜外血贴可使血肿快速消退并实现良好恢复。
