Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
World Neurosurg. 2021 Jun;150:133-139. doi: 10.1016/j.wneu.2021.03.115. Epub 2021 Mar 30.
Spontaneous spinal cerebrospinal fluid (CSF) leak is a condition that commonly presents with debilitating positional headaches. Often, the cause of the leak is located in the spine. Although often cured with conservative management, including epidural blood patching, a subset of patients are refractory to this initial management. Determining the focal location of the spinal leak can, in some patients, require several imaging modalities. Treatment similarly involves multiple options, including targeted epidural blood and/or fibrin patching as well as surgical closure. In this article, we review the current literature regarding this challenging condition and present an algorithm for management.
自发性脊柱脑脊液（CSF）漏是一种常见的以使人虚弱的位置性头痛为表现的疾病。通常，漏口位于脊柱。尽管保守治疗（包括硬膜外血贴补）常能治愈，但仍有一部分患者对此初始治疗无反应。在某些患者中，确定脊柱漏口的焦点位置可能需要多种成像方式。治疗方法也同样包括多种选择，包括靶向硬膜外血和/或纤维蛋白贴补以及手术修复。本文我们回顾了关于这种具有挑战性的疾病的现有文献，并提出了一种治疗方法的算法。
