Antonescu-Ghelmez Dana, Butnariu Ioana, Antonescu Florian, Maier Cristina, Moraru Adriana, Bucur Amanda Ioana, Anghel Daniela Nicoleta, Tuţă Sorin
Department of Neurology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Department of Neurology, National Institute of Neurology and Neurovascular Diseases, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Front Neurol. 2023 Feb 23;14:1132793. doi: 10.3389/fneur.2023.1132793. eCollection 2023.
Cerebrospinal fluid (CSF) leakage is considered the cause of spontaneous intracranial hypotension (SIH), an important etiology for new daily persistent headaches and a potentially life-threatening condition. Minor traumatic events rarely lead to CSF leakage, contrasting with iatrogenic interventions such as a lumbar puncture or spinal surgery, which are commonly complicated by dural tears. Most meningeal lesions are found in the cervicothoracic region, followed by the thoracic region, and rarely in the lumbar region, and extremely rarely in the sacral region. We describe two patients admitted to our hospital for severe headaches aggravated in the orthostatic position, with a recent history of minor trauma and sustained physical effort, respectively. In the first case, a bone fragment pierced an incidental congenital meningocele creating a dural fistula. An extensive extradural CSF collection, spanning the cervicothoracic region (C4-T10), was described in the second case. In both patients, the clinical evolution was favorable under conservative treatment.
脑脊液（CSF）漏被认为是自发性颅内低压（SIH）的病因，SIH是新发每日持续性头痛的重要病因，也是一种潜在的危及生命的疾病。轻微创伤事件很少导致脑脊液漏，这与腰椎穿刺或脊柱手术等医源性干预形成对比，后者通常会因硬脑膜撕裂而出现并发症。大多数脑膜病变见于颈胸段，其次是胸段，很少见于腰段，极罕见于骶段。我们描述了两名因严重头痛入院的患者，分别有近期轻微创伤史和持续体力劳动史，头痛在直立位时加重。在第一例中，一块骨碎片刺破了一个偶然发现的先天性脑脊膜膨出，形成了一个硬脑膜瘘。在第二例中，描述了一个广泛的硬膜外脑脊液聚集区，跨越颈胸段（C4 - T10）。在这两名患者中，保守治疗下临床病情均呈良性发展。
