特发性低颅压头痛的临床及影像学特点  

ClINICAL AND NEUROIMAGING CHARACTERISTICS OF SPONTANEOUS INTRACRANIAL HYPOTENSION

作　　者：董钊[1] 于生元[1] 陈志晔[2] 刘若卓[1] 张家堂[1] 黄旭升[1] 蒲传强[1] 

机构地区：[1]中国人民解放军总医院神经内科,北京100853 [2]中国人民解放军总医院放射科,北京100853

出　　处：《中国疼痛医学杂志》2011年第3期153-155,共3页Chinese Journal of Pain Medicine

摘　　要：目的:探讨特发性低颅压头痛的临床及影像学特点。方法:回顾性分析29例特发性低颅压头痛患者的临床表现、腰椎穿刺结果、头颅MR I特征以及治疗方法。结果:28例患者存在体位性头痛,卧位时缓解,1例患者出现体位性头晕;28例腰穿压力低,其中压力为0 mm H2O者9例,蛋白增高是较常见的脑脊液改变;26例行头颅MR I检查,其中16例可见异常,9例为硬膜下出血或积液,9例为硬脑膜强化;除1例患者因硬膜下出血转至外科手术治疗外,其余均经保守治疗后痊愈。结论:熟悉特发性低颅压头痛的临床特点、脑脊液改变和头颅MR I特征,有利于早期诊断和治疗。Objective：To summarize the clinical and neuroimaging features of spontaneous intracranial hypotension（SIH）.Methods：Twenty-nine patients admitted between February 1996 and November 2007 with SIH were retrospectively reviewed.Clinical features,lumbar puncture results,brain magnetic resonance imaging（MRI） studies and treatment were analyzed.Results：Typical orthostatic headache and low CSF opening pressure were found in 28 cases.Twenty-six patients had cranial MRI examination.Nine patients showed diffuse pachymeningeal enhancement and nine cases showed subdural fluid collections on their T1-weighted MR images.Conservative therapies including hydration and bed rest were performed in all the patients.Twenty-eight patients showed good responses and only one case received surgical treatment for serious subdural haematoma.Conclusions：Clinical presentations,CSF features and neuroimaging findings are helpful in identifying the early diagnosis of SIH.

关 键 词：头痛 特发性低颅压 临床特点 磁共振成像(MRI) 

分 类 号：R741[医药卫生—神经病学与精神病学]