自发性低颅压综合征2例报告并文献复习

Spontaneous Intracranial Hypotension:Two Cases Report and Literature Review

目的:探讨自发性低颅压综合征(Spontaneous Intracranial Hypotension,SIH)的临床和影像学特征,提高诊治水平。方法:对自发性低颅压2例报告并文献复习。结果:2例自发性低颅压均有典型的直立性头痛以及头颅核磁共振(MRI)增强扫描所示的硬脑膜广泛异常强化。其中1例虽然腰椎穿刺并无颅内压降低,但颈部MRI抑脂相提示脑脊液外漏。结论:脑脊液漏可能是导致自发性低颅压的主要原因,腰椎穿刺测压不是诊断的唯一依据,典型的临床表现和影像学征象有助于诊断,内科保守治疗无效时应考虑硬膜外血液补片法治疗。

Objective：To explore the characteristics of clinical and MR imaging in Spontaneous Intracranial Hypotension and enhance the level of diagnosis and treatment of this disease. Methods：Two cases of SIH are reported and related literatures are reviewed. Results：Both of them had typical orthostatie headache and diffuse pachymeningeal hyperintensity on MRI. Although the opening CSF pressure in one of the patients was not below the normal range,there was evidence of CSF leakage in cervical MRI fat saturation sequence by an unexpected epidural fluid signal. Conclusions .. The leakage of Cerebral Spinal Fluid is the leading cause of SIH probably,a low pressure proved by lumber puncture is not the only condition to make the diagnosis. However,the typical clinical manifestations and the signs of MR imaging may lead to the final diagnosis. Epidural blood patching should be performed when the conventional managements are not effective.