脑脊液细胞学检测对以头痛起病的脑膜癌病诊断的意义

Value of cerebrospinal fluid cytology in diagnosis of meningeal carcinomatiosis with headache onset

目的探讨脑膜癌病的临床特点和诊断方法。方法回顾性分析以头痛为首发症状的患者41例,经脑脊液细胞学确诊为脑膜癌病28例,结合文献进行分析。结果经脑脊液细胞学检查发现异形细胞的患者共28例,余13例分别诊断为偏瘫性偏头痛1例,普通偏头痛2例,眼肌麻痹性偏头痛2例,特发性颅内压增高症3例,肌紧张性头痛3例,静脉窦血栓2例。结论脑膜癌病临床表现无特异性,临床上常以头痛起病,反复CSF细胞学检查是确诊的重要手段。

Objective To investigate the clinical features and diagnostic methods of meningeal carcinomatiosis.Methods By using the cerebrospinal fluid cytology of 41 patients with headache onset were retrospective analyzed and 28 of them were diagnosed to meningeal carcinomatosis.Results Heterocysts were found in the cerebrospinal fluid with 28 cases.The rest was 3 hemiplegic migraine,2 Common migraine,2 ophthalmoplegic migraine,3 idiopathic intracranial hypertension,3 myotonic headache and 2 venous sinus thrombus respectively.Conclusion There is no specific clinical manifestations with meningeal carcinomatosis and the headache is shown as the first symptom invariably.It is very important to detect the cerebrospinal fluid cytology repeatedly.