Siavoshi Sara, Dougherty Carrie, Ailani Jessica, Yadwadkar Kaustubh, Berkowitz Frank
Department of Neurology, Georgetown University Hospital, Washington, DC 20007, USA.
Brain Sci. 2016 Dec 29;7(1):3. doi: 10.3390/brainsci7010003.
We present a case of post-traumatic headache complicated by intracranial hypotension resulting in an acquired Chiari malformation and myelopathy with syringomyelia. This constellation of findings suggest a possible series of events that started with a traumatic cerebral spinal fluid (CSF) leak, followed by descent of the cerebellar tonsils and disruption of CSF circulation that caused spinal cord swelling and syrinx. This unusual presentation of post-traumatic headache highlights the varying presentations and the potential sequelae of intracranial hypotension. In addition, the delayed onset of upper motor neuron symptoms along with initially normal head computerized tomography scan (CT) findings, beg the question of whether or not a post-traumatic headache warrants earlier magnetic resonance imaging (MRI).
我们报告一例创伤后头痛合并颅内低压，导致获得性小脑扁桃体下疝畸形及脊髓空洞症伴脊髓病。这一系列的发现提示了可能的事件顺序，始于创伤性脑脊液漏，随后小脑扁桃体下移及脑脊液循环中断，进而导致脊髓肿胀和空洞形成。创伤后头痛的这种不寻常表现突出了颅内低压的不同表现形式及其潜在后遗症。此外，上运动神经元症状的延迟出现以及最初头部计算机断层扫描（CT）结果正常，引发了关于创伤后头痛是否需要更早进行磁共振成像（MRI）检查的问题。
