原发性低颅压综合征三例神经影像学报告

Neuroimage changes in 3 cases of spontaneous intracranial hypotension

报告3例原发性低颅压综合征（SIH）患者的头MRI及1例脊髓池造影结果，为国内首次报道。头MRI表现强化扫描时幕上硬脑膜及小脑幕呈弥漫性对称性增强。其原因是：①由于低颅压时硬脑膜微血管扩张后钆在微血管及间质的聚集。②局部脑组织移位：中脑导水管位置下移，基底池狭窄等。③脑室狭小。脊髓池造影发现同位素过早地出现在肾和膀胱，未见脑脊液外漏，提示脑脊液吸收过快是SIH的发病机理，其MRI改变为可逆性的。

Spontaneous intracranial hypotension (SIH), which is uncommon in clinic, is characterized by the spontaneous headache that occurs with upright posture and relieved with laydownposture. Neuroimaging of this syndrome have not been reported pachymeningeal enhancement ongadolinum-enhanced MRI which will essentially resolved after the symptoms disappeared. Wefound narrow hasal cistern in two cases and the iter is displaced downward on midsagital MRI inone case. We report one lumbar isotope cisternography which shows rapid CSF accumulation of radionucleide in bladder,that is considered to be the hyperabsorption of CSF,and significant CSF obstruction in the pathway due to the narrow hasal cistern. It supports that the CSF hyperabsorptionis the cause of SIH.