Xia Ping, Hu Xing-Yue, Wang Jin, Hu Bei-Bei, Xu Qing-Lin, Zhou Zhi-Jie, Lou Min
Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, China; Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, China.
Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, China; Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, China.
PLoS One. 2015 Apr 8;10(4):e0123616. doi: 10.1371/journal.pone.0123616. eCollection 2015.
Subdural haematoma (SDH) is a potentially life-threatening complication in patients with spontaneous intracranial hypotension (SIH). In serious cases, SIH patients who present with SDHs develop neurological deficits, a decreased level of consciousness, or cerebral herniation, and may even require an urgent neurosurgical drainage. Despite numerous publications on SDHs, few report its potential risk factors in patients with SIH. In this study, we retrospectively investigated 93 consecutive SIH patients and divided them into an SDH group (n = 25) and a non-SDH (NSDH) group (n = 68). The clinical and radiographic characteristics of these 93 patients were analyzed, and then univariate analysis and further multiple logistic regression analysis were performed to identify the potential risk factors for the development of SDHs. The univariate analysis showed that advanced age, male gender, longer clinical course, dural enhancement, and the venous distension sign were associated with the development of SDHs. However, multivariate analysis only included the latter three factors. Our study reveals important radiological manifestations for predicting the development of SDHs in patients with SIH.
硬膜下血肿(SDH)是自发性颅内低压(SIH)患者中一种潜在的危及生命的并发症。在严重情况下,出现SDH的SIH患者会出现神经功能缺损、意识水平下降或脑疝,甚至可能需要紧急神经外科引流。尽管有大量关于SDH的文献,但很少有报道其在SIH患者中的潜在危险因素。在本研究中,我们回顾性调查了93例连续的SIH患者,并将他们分为SDH组(n = 25)和非SDH(NSDH)组(n = 68)。分析了这93例患者的临床和影像学特征,然后进行单因素分析和进一步的多因素逻辑回归分析,以确定SDH发生的潜在危险因素。单因素分析显示,高龄、男性、病程较长、硬脑膜强化和静脉扩张征与SDH的发生有关。然而,多因素分析仅纳入了后三个因素。我们的研究揭示了预测SIH患者发生SDH的重要影像学表现。