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一氧化碳导致的颅内高压和 Chiari 1 畸形伴睡眠呼吸暂停综合征患者的高振幅 B 波,经 CPAP 治疗后缓解。

CO-induced intracranial hypertension and high-amplitude B-waves in a patient with Chiari 1 malformation and sleep apnea syndrome that resolved following CPAP therapy.

机构信息

Neurosurgery Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.

Neurotrauma and Neurosurgery Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.

出版信息

Acta Neurochir (Wien). 2021 Nov;163(11):3075-3082. doi: 10.1007/s00701-021-04717-2. Epub 2021 Feb 2.

DOI:10.1007/s00701-021-04717-2
PMID:33528722
Abstract

Headaches and cognitive impairment in the elderly population have been described as symptoms related to obstructive sleep apnea (OSA). Although papilledema has been observed in some of these patients, suggesting intracranial hypertension (ICH), there are only a few studies in which intracranial pressure (ICP) has been continuously measured in patients with OSA without neurological disease. We present a patient diagnosed with Chiari Type 1 malformation and OSA, who present normal ICP recording during the day and nocturnal ICH associated with high amplitude B-waves and hypercapnia during obstructive apneas, which disappeared following continuous positive airway pressure (CPAP) therapy. The normalization of the cerebral and respiratory parameters with CPAP therapy is important for performing the correct treatment in these patients.

摘要

老年人的头痛和认知障碍被描述为与阻塞性睡眠呼吸暂停(OSA)相关的症状。尽管一些患者出现了视乳头水肿,提示颅内压升高(ICH),但仅有少数研究连续测量了无神经系统疾病的 OSA 患者的颅内压(ICP)。我们介绍了一位被诊断为 Chiari 1 型畸形和 OSA 的患者,该患者在白天的 ICP 记录正常,而在阻塞性呼吸暂停期间伴有高振幅 B 波和高碳酸血症的夜间 ICH,在接受持续气道正压通气(CPAP)治疗后消失。CPAP 治疗使脑和呼吸参数正常化对于对这些患者进行正确治疗很重要。

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本文引用的文献

1
Influence of mild-moderate hypocapnia on intracranial pressure slow waves activity in TBI.轻-中度低碳酸血症对 TBI 患者颅内压慢波活动的影响。
Acta Neurochir (Wien). 2020 Feb;162(2):345-356. doi: 10.1007/s00701-019-04118-6. Epub 2019 Dec 16.
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Relationship between obstructive sleep apnoea syndrome and essential hypertension: a dose-response meta-analysis.阻塞性睡眠呼吸暂停综合征与原发性高血压的关系:一项剂量-反应荟萃分析。
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6
Resolution of papilledema associated with OSA treatment.与 OSA 治疗相关的视盘水肿消退。
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7
Posture-induced changes in intracranial pressure: a comparative study in patients with and without a cerebrospinal fluid block at the craniovertebral junction.姿势引起的颅内压变化:颅颈交界处有无脑脊液梗阻患者的比较研究
Neurosurgery. 2006 May;58(5):899-906; discussion 899-906. doi: 10.1227/01.NEU.0000209915.16235.6D.
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Monitoring and interpretation of intracranial pressure.颅内压的监测与解读
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Sleep apnea and intracranial hypertension in men.男性的睡眠呼吸暂停与颅内高压
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10
Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr.基于人群的30至70岁受试者样本中的阻塞性睡眠呼吸暂停低通气及相关临床特征
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