低颅压综合征合并颅内静脉血栓2例并文献回顾分析

Two cases of Intracranial hypotension syndrome associated with cerebral venous thrombosis and literature review

目的总结分析低颅压综合征(SIH)合并颅内静脉血栓形成(CVT)的临床表现,诊断和治疗方法。方法报道2例低颅压综合征合并颅内静脉血栓形成,并回顾文献报道15例同类病例,分析其临床特征、影像学表现、治疗和病理生理机制。结果17例患者均以亚急性起病,其中14例患者表现为体位性头痛。常见的伴随症状有恶心、呕吐、复视、耳鸣等。所有患者的影像学检查都存在SIH和CVT的表现,头部核磁共振(MRI)加静脉成像(MRV)是诊断颅内静脉血栓形成的主要手段。结论低颅压综合征是颅内静脉血栓形成的危险因素之一,了解两者内在的病理生理联系和临床特征有利于对该病的早期诊断和及时治疗。

Objective Intracranial hypotension syndrome （1H） is rarely associated with cerebral venous thrombosis （ CVT）, so we demonstrated the clinical features, radiological appearances, pathogenesis and treatment strategies of intracranial hypotension syndrome associated with cerebral venous thrombosis. Method We reported two cases with intracranial hypotension syndrome followed by development of cerebral venous thrombosis, and reviewd the clinical features and radiological characteristics of 15 patients documented in English literature. Result Among 17 patients, 14 had postural headache. The most common symptoms included nausea, vomiting, visual symptoms and auditory or vestibular symptoms. Imaging features of SIH and CVT coexisted in all patients. Changes in pattern of headaches and MRI findings demonstrated that cerebral venous thrombosis followed intracranial hypotension syndrome. Conclusion IH may constitute an additional risk factor for CVT. The clinical course and imaging findings of these patients not only provide some insight into the pathophysiological relationship between CVT and IH, but modify our knowledge on IH and CVT that allows for early diagnosis and eftective treatment.