自发性低颅压综合征12例分析并文献复习

A report of 12 patients with spontaneous intracranial hypotension syndrome and review of literatures

目的探讨自发性低颅压综合征的临床特点。方法回顾性分析近8年收入院的自发性低颅压综合征患者12例,结合文献复习对其病因、临床表现、诊断依据及治疗预后进行分析。结果 9例(75.0%)患者急性起病,3例(25.0%)亚急性起病。体位性头痛为其核心症状,有其他非特异性伴随表现。头部磁共振成像有较多阳性发现。腰椎穿刺可协助明确诊断。卧床补液治疗均得到缓解,其中1例患者复发。结论对于体位性头痛患者应该想到自发性低颅压综合征,尽快明确诊断,卧床、多饮水及足量补液等治疗,一般来说多数患者预后较好。

Objective To explore the clinical characteristics of spontaneous intracranial hypotension syndrome. Methods The clinical data of 12 patients with spontaneous intracranial hypotension syndrome in this hospital during recent 8 years were retrospectively analyzed. The literature review was undertaken to summarize the current advance in etiological factors,pathogenesis,clinical manifestations and prognosis. Results Among them,the acute onset had been seen in 9 patients（75.0%）,and subacute onset had been seen in three patients（25.0%）. Their main symptoms were postural headache followed with some nonspecific manifestations. The cerebral MRI scanning provided a lot of positive findings. Lumbar puncture could assist in the diagnosis of this syndrome. Rehydration therapy was effective. Recrudescence was found in one patient. Conclusion The diagnosis of spontaneous intracranial hypotension syndrome should be suspected in patients with postural headache. Early diagnosis and treatment with lying on bed,generously drinking water,adequate rehydration are important,most of these patients have fovourable prognosis.