22例特发性低颅压综合征的临床与MRI分析

Analysis of the clinical and imaging characteristics in 22 patients with spontaneous intracranial hypotension syndrome

目的探讨特发性低颅压综合征(SIHS)的临床特点、诊断及鉴别诊断。方法回顾性分析22例SIHS患者的临床表现、腰穿和头颅影像学特征。结果22例患者均有体位性头痛,卧位时缓解;脑脊液压力50～70mm H2O9例,20～50mm H2O6例,7例未测出。部分轻度白细胞增多和蛋白增高;20例行头颅MRI检查,其中14例显示脑膜强化。结论认识SIHS的临床特点、脑脊液变化和头颅MRI强化的特征,是诊断的关键。

Objective To discuss the clinical features, diagnosis and differential diagnosis of spontaneous intracranial hypotension syndrome （SIHS）. Methods The clinical manifestation, lumbar puncture results and the imaging findings of 22 patients with SIHS were retrospectively analyzed. Results All of the patients had postural headache, which could be alleviated by lying. And they also had low CSF pressure, which was below 70 mmH2O. Some of them had increased WBC and high CSF protein. Twenty patients had brain magnetic resonance imaging （MRI） examination, 14 cases showed meningeal enhancement. Conclusions SIHS can present with various clinical presentations,CSF features and neuroimaging findings are helpful in establishing the diagnosis.