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脑脊液漏所致自发性颅内低压的诊断与治疗

Diagnosis and treatment of spontaneous intracranial hypotension due to cerebrospinal fluid leakage.

作者信息

Zheng Yake, Lian Yajun, Wu Chuanjie, Chen Chen, Zhang Haifeng, Zhao Peng

机构信息

Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe East R, Zhengzhou, 450052 Henan People's Republic of China.

The First People's Hospital of Zhengzhou, Zhengzhou, China.

出版信息

Springerplus. 2016 Dec 22;5(1):2108. doi: 10.1186/s40064-016-3775-z. eCollection 2016.

Abstract

INTRODUCTION

Spontaneous intracranial hypotension is one of the causes of a postural headache in young people. In this study, the diagnosis and treatment results of a case of intracranial hypotension headache due to spinal cerebrospinal fluid leakage were reported. Up to now, there is not absolutely effective treatment for intracranial hypotension headache.

CASE DESCRIPTION

A 32-year-old woman complained, a headache after prolonged sitting that presented with nausea; vomiting; increased pain during walking; and decreased or absent pain after lying down. The dramatic improvement of this cephalalgia with epidural blood patch treatment confirmed the diagnosis.

DISCUSSION AND EVALUATION

To the best of our knowledge, this is the first reported of radiographic contrast before and after epidural blood patch. Improved clinical diagnosis and treatment of spontaneous intracranial hypotension. The patient didn't feel any discomfort, no complications such as infection etc. were observed. A small dose of intrathecal gadolthis is the first reported case ofinium during CEMRM allows for improved detection of CSF leakage.

CONCLUSIONS

Leakage of spinal CSF is a major cause of spontaneous intracranial hypotension. In order to improve clinical diagnosis and provide effective treatment, the precise etiology of spontaneous intracranial hypotension should be investigated in each patient.

摘要

引言

自发性颅内低压是年轻人体位性头痛的病因之一。本研究报告了一例因脊髓脑脊液漏导致的颅内低压性头痛的诊断及治疗结果。目前,对于颅内低压性头痛尚无绝对有效的治疗方法。

病例描述

一名32岁女性主诉,长时间坐位后出现头痛,伴有恶心、呕吐,行走时疼痛加剧,躺下后疼痛减轻或消失。硬膜外血贴治疗后头痛明显改善,确诊为此病。

讨论与评估

据我们所知,这是首次报道硬膜外血贴前后的影像学对比情况。改善了自发性颅内低压的临床诊断和治疗。患者未感到任何不适,未观察到感染等并发症。在对比增强磁共振成像(CEMRM)期间使用小剂量鞘内钆喷酸葡胺是首次报道的病例,有助于提高脑脊液漏的检测率。

结论

脊髓脑脊液漏是自发性颅内低压的主要原因。为改善临床诊断并提供有效治疗,应针对每位患者调查自发性颅内低压的确切病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e12c/5179475/3042ea0ee09c/40064_2016_3775_Fig1_HTML.jpg

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