颅内低压综合征合并新型冠状病毒感染12例临床分析  

Clinical analysis of 12 cases of intracranial hypotension syndrome complicated with novel coronavirus pneumonia

作　　者：张朋 赵智亨 程明 廉叶 陶珍 ZHANG Peng;ZHAO Zhiheng;CHENG Ming;LIAN Ye;TAO Zhen(Department of Neurology,The 971th Hospital of PLA Navy,Qingdao,Shandong 266071,China;Department of Neurology,Shengli Oilfield Central Hospital,Dongying,Shandong 257009,China;Department of Neurology,The 960th Hospital of the Joint Logistics Support Force of PLA,Ji'nan,Shandong 250031,China)

机构地区：[1]解放军海军第九七一医院神经内科,山东青岛266071 [2]胜利油田中心医院神经内科,山东东营257009 [3]解放军联勤保障部队第九六〇医院神经内科,山东济南250031

出　　处：《安徽医药》2024年第12期2502-2507,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨、总结颅内低压综合征(IHS)合并新型冠状病毒(新冠病毒)感染的病例特点。方法回顾性分析2022年10月至2023年2月在解放军海军第九七一医院、解放军联勤保障部队第九六〇医院及胜利油田中心医院住院治疗的12例IHS合并新冠病毒感染病人的临床、检验及影像学等资料。结果12例病人中9例为IHS病程中合并新冠病毒感染,3例为新冠病毒感染后合并IHS。9例因IHS起病者中,轻型感染4例,中型感染4例,重型感染1例,合并感染后出现头痛加重或头痛性质者改变7例,嗅觉下降1例,肌肉疼痛2例,肢体乏力4例,记忆力减退加重1例。3例因新冠病毒感染起病者中,轻型感染1例,中型感染2例,3例均在治疗过程中出现头痛症状在直立位后明显加重的表现。12例病人中有6例纤维蛋白原升高,5例D-二聚体升高,5例白细胞介素-6升高,均系在新冠病毒感染后出现。3例在病程中合并脑静脉血栓形成(CVT),分别累及上矢状窦、右侧中央后静脉和右侧横窦及乙状窦,其中2例出现症状性癫痫。12例病人除1例遗留记忆力减低,其余病人预后良好。结论合并新冠病毒感染可使IHS症状复杂化,给予心理疏导可能会减少IHS合并新冠病毒感染病人认知障碍的发生。IHS合并新冠病毒感染可能会增加CVT的发病率,应注意监测D-二聚体、纤维蛋白原、白细胞介素-6等指标,高龄、凝血障碍病人预防性使用抗凝治疗可能会降低CVT发生风险。Objective To explore and summarize the characteristics of intracranial hypotension syndrome(IHS)complicated with novel coronavirus pneumonia.Methods The clinical,laboratory and imaging data of 12 patients with IHS complicated with novel coronavirus pneumonia who were hospitalized in The 971th Hospital of PLA Navy,The 960th Hospital of the Joint Logistics Support Force of PLA and Shengli Oilfield Central Hospital from October 2022 to February 2023 were analyzed retrospectively.Results Among the 12 patients,9 cases were complicated with novel coronavirus pneumonia during the course of IHS,and 3 cases were complicated with IHS after novel coronavirus pneumonia.Among the 9 patients who started with IHS,4 cases were mild infection,4 cases were moderate infection,1 case was severe infection.After complicated infection,7 cases had headache aggravation or property change,1 case had decreased smell,2 cases had muscle pain,4 cases had limb weakness,and 1 case had decreased memory.Among the 3 patients who started with novel coronavirus pneumonia,1 case had mild infection and 2 cases had moderate infection.All 3 cases had headache symptoms that were significantly aggravated after standing upright during the treatment.Among the 12 patients,fibrinogen increased in 6 cases,D-dimer increased in 5 cases,and interleukin-6 increased in 5 cases,all of which occurred after novel coronavirus pneumonia.Three cases were complicated with cerebral venous thrombosis(CVT)during the course of the disease,involving the superior sagittal sinus,right posterior central vein,and right transverse and sigmoid sinuses,respectively.Among them,2 cases developed symptomatic epilepsy.The prognosis of the 12 patients was good,except for 1 patient with residual memory impairment.Conclusions Co-infection with SARS-CoV-2 can complicate the symptoms of IHS,and psychological counseling may reduce the occurrence of cognitive impairment in patients with novel coronavirus pneumonia.IHS combined with novel coronavirus pneumonia may increase the incidence rate of

关 键 词：颅内低压 新型冠状病毒感染 脑静脉 颅内血栓形成 癫痫发作 

分 类 号：R741[医药卫生—神经病学与精神病学] R511[医药卫生—临床医学]