非占位病变颅内压增高的诊断与处理

Diagnosis and management of non space occupying lesion intracranial hypertension

目的：报道１６４例非占位病变颅内压增高的诊断与临床处理经验．临床资料：本组病因以头部创伤、病毒或细菌感染较常见（８６％），其次为内分泌障碍、蛛网膜下腔出血或贫血等因素（１４％）．全组病例均有颅内压增高和眼部症状（如视力减退及视乳头水肿）征象．治疗措施包括应用皮质类固醇或高渗脱水药物、多次腰椎穿刺、脑室持续引流或颞肌下减压术等．治疗结果：１０３例头痛及伴随的其他症状消除，且ＩＣＰ达到正常水平（６２．８％）；３５例症状与体征明显改善（２１．３％），无死亡．结论：作者认为本病一旦明确诊断后，应采取积极降颅压处理，可获较好疗效．

Objective: The authors presented the experiences of diagnosis and clinical management in 164 patients with non space occupying lesion intracranial hypertension. Material: The head trauma, viral or bacterial infection seemed to be the commonest causes of the disease (86%), and the other 14% of them were due to the endocrine dysfunction, subarachnoid hemorrhage or anaemia in this group. All of the patients showed the clinical features of increased intracranial pressure and the ophthalmic symptoms such as visual blurring and papilloedema. The treatment measures for these patients included the administration of corticosteroids and osmolar loads, and repeated lumbar punctures, continuous ventricular drainages or subtemporal decompressions, etc. Results: 103 patients (62.8%) had a satisfactory recovery, in which their headache relieved, other symptoms abolished, and the ICP reached normal level. Thirty five cases (21.3%) had obvious improvement in their symptoms and signs, and no patient died in our series. Conclusions: The authors considered that the early diagnosis and treatment should be given to the patients and better therapeutic effect could be achieved.