自发性低颅内压综合征七例报告  

Spontaneous intracranial hypotension syndrome: 7 cases of reports

作　　者：陈淑兰[1] 鄂紫娟[2] 刘颖晖 吴哲[1] 

机构地区：[1]中国医科大学第一临床学院神经内科,沈阳110001 [2]沈阳医学院第二附属医院,沈阳110001

出　　处：《中华神经科杂志》1999年第5期275-277,共3页Chinese Journal of Neurology

摘　　要：目的研究自发性低颅内压综合征（SIH）的临床、脑脊液（CSF）和影像学的改变。方法对1年8个月时间收治的7例SIH患者观察其临床表现、CSF压力、生化指标及头颅CT和MRI增强扫描。结果当患者起立时即出现头痛、呕吐及颈强直，卧位时症状消失。CSF压力均低于7cmH2O。其中5例呈血性CSF，蛋白增高似蛛网膜下腔出血（SAH）。CT示脑室缩小。增强MRI示硬脑膜强化、硬脑膜下积液、桥脑扁平、桥池变窄及小脑扁桃体下疝的特征性改变。当临床症状好转时，其CSF压力和生化指标恢复正常。结论了解SIH的临床、CSF和MRI表现至关重要，因其极易与SAH相混淆。Objective To study the clinical features of spontaneous intracranial hypotension sydrome(SIH) and its characteristic changes in cerebrospinal fluid(CSF), CT and MRI. Methods 7 cases of SIHpatients , treated during the past 1 year and 8 months, were analyzed. Their clinical manifestations were observedcarefull, CSF pressure and biochemistry were measured and cranial CT, as well as MRI enhancement scanningswere detected.Results All the patients had headache and vomiting on standing up and meningeal irritation signswere positive. Their CSF pressures were < 0 or below 7 cmH2O0. 5 cases had bloody CSF with increased proteinlevel,resembling subarachnoid hemorrage (SAH). The ventricle became small in CT and MRI demonstrated thefeatures of diffuse pachymeningeal gadolinium enhancement, evidence of descent of the brai (86%) thatsometimes resembles type I Chiari malformation,and subdural collections of fluid. Conclusions It is important torecognize the clinical manifestations of SIH, particularly the features of CSF and MRI. In some cases, specialattention is needed to differentiate with SAH to avoid misdiagnosis.

关 键 词：低颅内压 成像 脑脊髓液 NMR 

分 类 号：R742.89[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]