Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave., Room L352, San Francisco, CA, 94143, USA.
Department of Radiology, The Permanente Medical Group, Kaiser Permanente Medical Center, Santa Clara, CA, USA.
Pediatr Radiol. 2021 Oct;51(11):2093-2097. doi: 10.1007/s00247-021-05132-6. Epub 2021 Jul 20.
Spontaneous intracranial hypotension is an uncommon etiology of secondary headaches in children. We report a unique case of a girl with kaposiform lymphangiomatosis who developed postural headaches and imaging features of spontaneous intracranial hypotension without a spinal extradural collection. The girl underwent dynamic computed tomography myelography which revealed a cerebrospinal fluid (CSF)-lymphatic fistula related to a lymphatic malformation associated with the right T10 nerve. She underwent surgical ligation of the CSF-lymphatic fistula, resulting in resolution of the headaches. Spinal CSF-lymphatic fistulas are rare and have previously been reported in two patients with Gorham-Stout disease. The current report suggests that patients with systemic lymphatic anomalies who develop postural headaches should undergo evaluation for spontaneous intracranial hypotension and a CSF-lymphatic fistula. If discovered, surgical ligation is a potential treatment.
自发性颅内低血压是儿童继发性头痛的一种不常见病因。我们报告了一例女孩患有kaposiform 淋巴管瘤病，其出现体位性头痛和自发性颅内低血压的影像学特征，但没有脊柱硬膜外积液。该女孩接受了动态计算机断层脊髓造影，显示与右侧 T10 神经相关的脑脊液-淋巴管瘘与淋巴管畸形有关。她接受了脑脊液-淋巴管瘘的手术结扎，头痛得到缓解。脊柱脑脊液-淋巴管瘘很罕见，以前曾有两名 Gorham-Stout 病患者报道过。本报告提示，出现体位性头痛的系统性淋巴异常患者应接受自发性颅内低血压和脑脊液-淋巴管瘘的评估。如果发现，手术结扎是一种潜在的治疗方法。
