自发性低颅压伴复视(附5例报告及文献复习)  

Clinical Analysis of Five Patients of Spontaneous Intracranial Hypotension with Diplopia and the Relevant Literature Reviewed

作　　者：王霏 李军杰[1] 郭百海[2] 李倩 丁锚 王翠云 王震 WANG Fei;LI Jun-jie;GUO Bai-hai;LI Qian;DING Mao;WANG Cui-yun;WANG Zhen(Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Neurology,Jiuquan People's Hospital,Jiuquan 735000,China;Department of Neurology,Qingyang Second People's Hospital,Qingyang 745000,China;Department of Brain Disease,Heze Hospital of Traditional Chinese Medicine,Heze 274000,China)

机构地区：[1]首都医科大学宣武医院神经内科,北京100053 [2]酒泉市人民医院神经内科,酒泉735000 [3]庆阳市第二人民医院神经内科,庆阳745000 [4]菏泽市中医医院脑病科,菏泽274000

出　　处：《中国临床神经科学》2025年第1期73-78,共6页Chinese Journal of Clinical Neurosciences

摘　　要：目的 分析自发性低颅压伴复视患者的临床特征。方法 回顾性分析2020年10月至2023年5月诊治的126例自发性低颅压患者的临床资料,其中5例患者伴有复视,对其临床表现、影像学特征、治疗及预后进行分析。结果5例患者均表现为体位性头痛伴复视,3例左侧外展神经麻痹,2例双侧外展神经麻痹。头颅MRI均符合低颅压改变,脊髓磁共振水成像(MRM)均显示脊髓长节段硬脊膜外或神经根周围积液,经硬膜外血贴术治疗后复视均缓解。结论 复视是自发性低颅压重要的伴随症状,临床中应重视其诊断。Aim To analyze the clinical features of five patients with spontaneous intracranial hypotension with diplopia.Methods The clinical data of 126 patients with spontaneous intracranial hypotension from October 2020 to May 2023 were retrospectively reviewed,including 5 patients with diplopia,and their clinical manifestations,imaging features,treatment and prognosis were analyzed Results All the five patients had orthostatic headaches with diplopia,three patients had left adductor nerve palsy and two patients had bilateral adductor nerve palsy.Brain magnetic resonance imaging were consistent with spontaneous intracranial hypotension changes and magnetic resonance myelography showed longitudinal extradural collection in all the patients.Diplopia was alleviated after the treatment with epidural blood patches.Conclusion Diplopia as an important concomitant symptom of spontaneous intracranial hypotension should be emphasized in clinical practice.

关 键 词：自发性低颅压 复视 硬膜外血贴术 

分 类 号：R742[医药卫生—神经病学与精神病学]