老年人原发性低颅压综合征的临床与影像学分析  

Primary intracranial hypotension syndrome in the elderly:clinical and image characteristics

作　　者：范超平 陈琼[2] 王蕾 周秀丽 

机构地区：[1]河南信阳市中心医院神经内科,信阳464000 [2]河南信阳农业高等专科学校,信阳464000

出　　处：《中国实用神经疾病杂志》2007年第1期50-51,共2页Chinese Journal of Practical Nervous Diseases

摘　　要：目的研究老年人原发性低颅压综合征(PIH)的临床及影像学特点,提高对本病的认识。方法19例老年人PIH患者,观察其临床特点、脑脊液(CSF)压力、生化、头颅CT及MRI扫描。结果起立性头痛和呕吐是其显著的特征,CSF压力均<7cmH2O;部分病人脑膜刺激征阳性。CT可见脑室系统、脑池及脑沟变窄、缩小,部分患者可见硬膜下积液;MRI增强示硬脑膜强化、硬膜下积液、桥脑扁平、桥池变窄及小脑扁桃体疝。结论老年人PIH发生率低,容易误诊,了解老年人PIH的临床、CSF、CT及MRI的特异性改变,对正确诊断PIH至关重要。Objective To study the clinical features of primary intracranial hypotension syndrome（PIH） and its characteristic changes in CT and MRI. Methods 19 cases PIH in elderly patients,treated from 2000 to 2005 were analyzed. Their clinical manifestations were observed carefully, CSF pressure and biochemistry were measured and cranial CT as well as MRI enhancement scanning was detected. Results All patients had headache and vomiting on standing up. Their CSF pressures were below 7 cmH20, meningeal irritation signs in some patients were positive, the ventricle became small in CT and MRI demonstrated the features of diffuse pachymeningeal gadolinium enhancement,evidence of descent of the brain that sometimes resembles type I chiari malformation, and subdural collections of fluid. Conclusion PIH in the elderly had low incidence. It is important to recognize the clinical manifestations of PIH, particularly the features of CSF and MRI.

关 键 词：低颅内压 磁共振成像 脑脊髓液 

分 类 号：R446.14[医药卫生—诊断学]