Department of Radiology, The Permanente Medical Group, 23545Kaiser Permanente Medical Center, Santa Clara, CA, USA.
Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
J Intensive Care Med. 2022 May;37(5):618-624. doi: 10.1177/08850666211024886. Epub 2021 Jun 29.
Spontaneous intracranial hypotension typically manifests with orthostatic headaches and is caused by spinal dural tears, ruptured meningeal diverticula, or CSF-venous fistulas. While most patients are diagnosed and treated in the outpatient setting, some patients will occasionally present in the emergent ICU setting due to subdural hematomas, coma, or downward brain herniation. In this review paper, we will discuss the diagnostic and treatment steps that intensivists can undertake to coordinate a team approach to successfully manage these patients. A brief general overview of spontaneous intracranial hypotension will also be discussed.
自发性颅内低血压通常表现为直立性头痛,由脊髓硬脑膜撕裂、脑膜憩室破裂或 CSF-静脉瘘引起。虽然大多数患者在门诊被诊断和治疗,但由于硬膜下血肿、昏迷或向下脑疝,一些患者偶尔会在急诊 ICU 出现。在这篇综述文章中,我们将讨论加强治疗师可以采取的诊断和治疗步骤,以协调团队方法成功管理这些患者。还将简要讨论自发性颅内低血压的一般概述。