自发性低颅压综合征临床研究

Clinical study of spontaneous intracranial hypotension

目的研究自发性低颅压综合征(SIH)的临床、脑脊液及影像学特点。方法回顾性分析14例SIH住院病例,观察其临床表现、脑脊液压力、常规生化指标及头颅影像学特点。结果所有病例均有特征性的直立性头痛,多数患者以额颞部头痛为主,伴随有恶心、耳鸣、听力下降等症状,可出现脑神经受累及脑膜刺激征,腰穿结果颅内压均低于70 mm H2O(1 cm H2O=0.098 kPa),脑脊液均有不同程度的细胞数和蛋白增高。头颅磁共振成像(MRI)加强扫描均有广泛脑膜强化。结论了解SIH临床、脑脊液及影像学特点至关重要,头颅MRI加强扫描是SIH检出的有效检查手段。

Objective To investigate clinical, MRI, radioisotope feature of the syndrome of spontaneous intracranial hypotension （SIH）. Methods Fourteen patients with headache related to the syndrome of spontaneous intracranial hypoternsion were investigated. The clinical representation, cerebrospinal fluid and MRI changes were observed. Results All the patients were characteristic of postural headache. They also have meningeal irritation signs. Most of their cerebrospinal fluid bad bled cell and protein increased. All of the 6 cases with gadolinium enhancement scan had positive results. Conclusion It is important to recognize the representation of spontaneous intracranial hypotension syndrome, especially changing in the features of cerebrospinal fluid, MRI gadolinium enhancement .scanning is of much help to make right diagnosis.