Department of Anaesthetics, Morriston Hospital, Swansea, UK.
Department of Internal Medicine, Morriston Hospital, Swansea, UK
BMJ Case Rep. 2021 Aug 17;14(8):e240936. doi: 10.1136/bcr-2020-240936.
Spontaneous intracranial hypotension (SIH) is characterised by postural headache and a cerebrospinal fluid (CSF) pressure of ≤6 cmH0 measured with the patient in the lateral decubitus position. Other symptoms include tinnitus, altered hearing, diplopia, photophobia, nausea and neck stiffness, and must not have occurred within a month of dural puncture. Symptoms typically remit after normalisation of CSF pressure or successful sealing of the CSF leak. An epidural blood patch (EBP) is a treatment option in those who have not responded to bed rest, fluids, non-steroidal anti-inflammatories or caffeine. We present a case of SIH successfully treated with both conservative measures and EBP. We compare our case with similar cases in the literature and summarise what is known about EBP for SIH to help clinicians take a more informed approach to managing such patients.
自发性颅内低血压（SIH）的特征是体位性头痛和脑脊液（CSF）压力≤6cmH2O，患者在侧卧位时测量。其他症状包括耳鸣、听力改变、复视、畏光、恶心和颈部僵硬，且这些症状必须在硬脑膜穿刺后一个月内未出现。症状通常在 CSF 压力正常化或 CSF 漏成功封堵后缓解。对于未对卧床休息、补液、非甾体抗炎药或咖啡因有反应的患者，硬膜外血贴（EBP）是一种治疗选择。我们报告了一例成功接受保守治疗和 EBP 治疗的 SIH 病例。我们将我们的病例与文献中的类似病例进行了比较，并总结了 EBP 治疗 SIH 的相关知识，以帮助临床医生更明智地管理此类患者。
