自发性低颅压研究进展  

Research progress of spontaneous intracranial hypotension

作　　者：高晓玉[1] 张颜波 GAO Xiaoyu;ZHANG Yanbo(Neurology Department,Yantai Yuhuangding Hospital,Yantai 264000,China;Neurology Department,The Second Affiliated Hospital of Shandong First Medical University,Taian 271000,China)

机构地区：[1]烟台毓璜顶医院神经内科,山东烟台264000 [2]山东第一医科大学第二附属医院神经内科,山东泰安271000

出　　处：《山东第一医科大学（山东省医学科学院）学报》2022年第7期544-547,共4页Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences

基　　金：山东省自然科学基金(ZR2012HQ014,ZR2015HL041);山东省医药卫生科技发展计划(2014WS0506);泰山医学院高层次课题培育计划(2016GCC02);烟台市重点研发计划(政策引导类)(2019NS139)。

摘　　要：自发性低颅压(spontaneous intracranial hypotension,SIH)通常由自发性脑脊液漏引起。典型表现为直立性头痛,但有些患者可有激素分泌异常、颅内静脉窦血栓形成、运动障碍、认知行为改变甚至昏迷等非典型表现,亦有部分患者颅内压正常。颅脑增强MRI表现为硬膜下积液、硬脑膜增强、静脉结构的充盈、垂体增大和大脑下垂。但与具有典型症状的SIH患者相比,非典型症状患者脑下垂的程度更严重。对于需要靶向硬膜外血贴治疗者,通过影像学检查定位脑脊液漏位置尤为重要。本文就SIH的非典型临床表现,脑脊液漏的定位、治疗等方面的进展作一综述。Spontaneous intracranial hypotension is a well-recognized sequel of a spontaneous cerebrospinal fluid leak.But not all patients with spontaneous intracranial hypotension have typical orthostatic headache.The patients may have hormonal abnormalities,subdural fluid collections and subdural hematomas,cerebral venous thrombosis,movement disorders,cognitive behavioral changes,coma and other atypical manifestations,and some patients have normal brain pressure.Typical Gd-enhanced MRI features are subdural fluid collections,enhancement of pachymeninges,engorgement of venous structures,pituitary enlargement,and sagging of the brain.However,compared with SIH patients with typical symptoms,patients with atypical symptoms have more severe sagging of the brain.For those who need targeted epidural blood patch therapy,it is needed to localize cerebrospinal fluid leaks.This article reviews the atypicalclinical manifestations,location of cerebrospinal fluid leaks and treatment of spontaneous intracranial hypotension.

关 键 词：自发性低颅压 非典型表现 脑脊液漏 

分 类 号：R741[医药卫生—神经病学与精神病学]