Kranz Peter G, Tanpitukpongse Teerath P, Choudhury Kingshuk Roy, Amrhein Timothy J, Gray Linda
Department of Radiology, Duke University Medical Center, USA.
Cephalalgia. 2016 Nov;36(13):1209-1217. doi: 10.1177/0333102415623071. Epub 2016 Jul 19.
Objectives To determine the proportion of patients with spontaneous intracranial hypotension (SIH) who had a cerebrospinal fluid (CSF) pressure >6 cm HO and to investigate the clinical and imaging variables associated with CSF pressure ( P) in this condition. Methods We retrospectively reviewed 106 patients with SIH. P was measured by lumbar puncture prior to treatment. Clinical and imaging variables - including demographic data, brain imaging results, symptom duration, and abdominal circumference - were collected. Univariate and multivariate analyses were performed to determine the correlation of these variables with P. Results Sixty-one percent of patients had a P between 6 and 20 cm HO; only 34% had a P ≤6 cm HO. The factors associated with increased P included abdominal circumference ( p < 0.001), symptom duration ( p = 0.015), and the absence of brain magnetic resonance imaging findings of SIH ( p = 0.003). A wide variability in P was observed among all patients, which was not completely accounted for by the variables included in the model. Conclusions Normal CSF pressure is common in patients with SIH; the absence of a low opening pressure should not exclude this condition. Body habitus, symptom duration, and brain imaging are correlated with P measurements, but these factors alone do not entirely explain the wide variability in observed pressures in this condition and this suggests the influence of other factors.
目的 确定脑脊液（CSF）压力>6 cm H₂O的自发性颅内低压（SIH）患者的比例，并研究与该情况下脑脊液压力（P）相关的临床和影像学变量。方法 我们回顾性分析了106例SIH患者。治疗前通过腰椎穿刺测量P。收集临床和影像学变量，包括人口统计学数据、脑部影像学结果、症状持续时间和腹围。进行单因素和多因素分析以确定这些变量与P的相关性。结果 61%的患者P在6至20 cm H₂O之间；只有34%的患者P≤6 cm H₂O。与P升高相关的因素包括腹围（p<0.001）、症状持续时间（p = 0.015）以及无SIH的脑磁共振成像表现（p = 0.003）。在所有患者中观察到P存在广泛差异，模型中纳入的变量并未完全解释这种差异。结论 正常脑脊液压力在SIH患者中很常见；脑脊液初压不低不应排除该病。体型、症状持续时间和脑部影像学与P测量值相关，但这些因素单独并不能完全解释该情况下观察到的压力的广泛差异，这表明存在其他因素的影响。
