Samadian Mohammad, Tavassol Hesameddin Hoseini, Eraghi Mohammad Mirahmadi, Ebrahimzadeh Kaveh, Hallajnejad Mohammad, Mousavinejad Seyed Ali, Rezaei Mirghaed Omidvar
Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Makhsoos St, South Karegar Ave, Tehran 1333635445, Iran.
Radiol Case Rep. 2023 May 29;18(8):2659-2662. doi: 10.1016/j.radcr.2023.04.047. eCollection 2023 Aug.
Intracranial hypotension (IH) represents a rare complication, mainly following cerebrospinal fluid (CSF) leakage at the thoracic or cervicothoracic junction level. Iatrogenic IH may be expected secondary to the previous surgery or other procedures invading the patient's dura. Magnetic resonance imaging (MRI), computerized tomography (CT) scan images, CT cisternography, and magnetic resonance cerebrospinal fluid flow (MR CSF) remains the modality of choice to establish the diagnosis. The patient is in her late sixth decade, reflecting a history of progressive headaches, nausea, and vomiting. Once a diagnosis of foramen magnum meningioma was established using MRI, total microscopic resection was applied. Brain sagging and subdural fluid collection were identified on postoperative day three, suggesting intracranial hypotension due to cerebrospinal fluid leakage. Diagnosing IH following the CSF leak during the postoperative phase remains challenging. Although rare, early clinical suspicion must be considered to establish the diagnosis.
颅内低压（IH）是一种罕见的并发症，主要发生在胸段或颈胸交界处脑脊液（CSF）漏之后。医源性IH可能继发于先前的手术或其他侵犯患者硬脑膜的操作。磁共振成像（MRI）、计算机断层扫描（CT）扫描图像、CT脑池造影和磁共振脑脊液流动（MR CSF）仍是确立诊断的首选方式。该患者为60多岁，有进行性头痛、恶心和呕吐病史。一旦通过MRI确诊为枕骨大孔脑膜瘤，便进行了全显微切除术。术后第三天发现脑下垂和硬膜下积液，提示脑脊液漏导致颅内低压。在术后阶段脑脊液漏后诊断IH仍然具有挑战性。尽管罕见，但必须考虑早期临床怀疑以确立诊断。
