共查询到20条相似文献,搜索用时 15 毫秒
1.
Merlo P Clerici AM Stival B Rebecchi V Noce M Mazza S 《The journal of headache and pain》2005,6(6):477-477
Spontaneous intracranial hypotension is a well defined entity, however it is characterised by a relevant clinical heterogeneity.
The main feature is orthostatic headache, often accompanied by other symptoms. The diagnosis is easily made in the presence
of orthostatic headache, excluding an obvious aetiology of low cerebrospinal fluid (CSF) pressure, and often there is no evidence
of direct or indirect CSF leak. 相似文献
2.
Morelli N Gallerini S Gori S Chiti A Cosottini M Orlandi G Murri L 《The journal of headache and pain》2006,7(4):211-213
Cervical spine manipulation
has been associated with several
disorders such as cervical arteries
dissection, but rarely has a relationship
with intracranial hypotension
been reported. We describe a
patient showing intracranial
hypotension syndrome following
chiropractic cervical spine treatment.
Magnetic resonance showed
the presence of dural leakage at
cervical level, suggesting the pathogenesis
of the syndrome. We state
that cervical spine manipulation
should be considered a treatment
with risk of neurological complications,
including the occurrence of
intracranial hypotension. 相似文献
3.
Donovan JS Kerber CW Donovan WH Marshall LF 《Archives of physical medicine and rehabilitation》2007,88(11):1472-1473
Donovan JS, Kerber CW, Donovan WH, Marshall LF. Development of spontaneous intracranial hypotension concurrent with grade IV mobilization of the cervical and thoracic spine: a case report.Spontaneous intracranial hypotension (SIH) has been clinically defined as the development of severe orthostatic headaches caused by an acute cerebrospinal fluid (CSF) leak. Typically, intracranial hypotension occurs as a complication of lumbar puncture, but recent reports have identified cases caused by minor trauma. We report a case of SIH secondary to a dural tear caused by a cervical and thoracic spine mobilization. A 32-year-old woman with SIH presented with severe positional headaches with associated hearing loss and C6-8 nerve root distribution weakness. CSF opening pressure was less than 5cmH2O and showed no abnormalities in white blood cell count. Cranial, cervical, and thoracic magnetic resonance imaging revealed epidural and subdural collections of CSF with associated meningeal enhancement. Repeated computed tomography myelograms localized the leak to multiple levels of the lower cervical and upper thoracic spine. A conservative management approach of bedrest and increased caffeine intake had no effect on the dural tear. The headache, hearing loss, and arm symptoms resolved completely after 2 epidural blood patches were performed. Practitioners performing manual therapy should be aware of this rare, yet potential complication of spinal mobilizations and manipulations. 相似文献
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5.
Dora Barkoula Nikolaos Bontozoglou Stylianos Gatzonis Damianos Sakas 《World Journal of Clinical Cases》2013,1(9):295-297
Intracranial hypotension syndrome (IHS) is a rare disorder characterized by a decrease in cerebrospinal fluid pressure to less than 60 mm H2O. The syndrome is associated with occipital headache radiating to the frontal and temporal zones. The current clinical case describes the manifestation of IHS in a twenty-five year old female with a history of suboccipital craniectomy due to Chiari I malformation nine years earlier. The patient was admitted to the hospital complaining about postural, mainly occipital, headache during the last three months, aggravated by being in an upright position. The magnetic resonance imaging (MRI) revealed engorgement of the dural venous sinuses, significant enlargement of the pituitary gland and download displacement or sagging of the brain with effacement of the perichiasmatic cisterns and the prepontine cistern, while the spinal T2W MRI revealed a 7 mm × 2.5 mm dural defect with an extradural cerebrospinal fluid collection at the dorsal soft tissues of the cervical spine. The previous imaging did not reveal subdural effusions. 相似文献
6.
BACKGROUNDIntracranial hypotension (IH) is a disorder involving cerebrospinal fluid (CSF) hypovolemia due to spontaneous or traumatic spinal CSF leakage and is easily being misdiagnosed or missed, especially in these patients without the prototypical manifestation of an orthostatic headache. At present, the management of IH with both cranial nerve VI palsy and bilateral subdural hematomas (SDHs) is still unclear.CASE SUMMARYA 67-year-old male Chinese patient complained of diplopia on the left side for one and a half mo. Computed tomography revealed bilateral SDHs and a midline shift. However, neurotrophic drugs were not effective, and 3 d after admission, he developed a non-orthostatic headache and neck stiffness. Enhanced magnetic resonance imaging revealed dural enhancement as an additional feature, and IH was suspected. Magnetic resonance myelography was then adopted and showed CSF leakage at multiple sites in the spine, confirming the diagnosis of having IH. The patient fully recovered following multiple targeted epidural blood patch (EBP) procedures.CONCLUSIONIH is a rare disease, and to the best of our knowledge, IH with diplopia as its initial and primary symptom has never been reported. In this study, we also elucidated that it could be safe and effective to treat IH patients with associated cranial nerve VI palsy and bilateral SDHs using repeated EBP therapy. 相似文献
7.
《Journal of Radiology Nursing》2020,39(4):327-330
Cerebrospinal fluid (CSF) leaks due to spinal procedures are commonly reported and can result in a condition known as intracranial hypotension. In rare cases, this can lead to a life-threatening situation if not properly diagnosed and treated. This case study discusses a rapidly decompensating patient that was found to have a CSF leak after an epidural placement for childbirth and made a full recovery after treatment with an epidural blood patch. 相似文献
8.
Russo A Tessitore A Cirillo M Giordano A De Micco R Bussone G Tedeschi G 《The journal of headache and pain》2011,12(4):493-496
Spontaneous intracranial hypotension is an uncommon cause of sudden and persistent headache: associated symptoms are common,
among which there are cranial nerve palsies, especially of the abducens nerve. We report a case of a 21-year-old man with
a transient and isolated third nerve palsy due to spontaneous intracranial hypotension. To our knowledge, there are only few
reports in the literature of such association. 相似文献
9.
Spontaneous intracranial hypotension is considered a rare disorder. We conducted a study on the frequency of spontaneous intracranial
hypotension in the emergency department (ED). We identified patients with spontaneous intracranial hypotension evaluated in
the ED of a large urban hospital between 1 January 2003 and 31 December 2006. For comparison, we also identified all patients
with spontaneous subarachnoid haemorrhage (SAH). Eleven patients with previously undiagnosed spontaneous intracranial hypotension
were evaluated in the ED during the four-year time period. All patients presented with positional headaches and the duration
of symptoms varied from one day to three months. None of the patients were correctly diagnosed with spontaneous intracranial
hypotension in the ED. During the same time period, 23 patients with aneurysmal SAH were evaluated. Spontaneous intracranial
hypotension is more common than previously appreciated and the diagnosis in the ED remains problematic. 相似文献
10.
11.
Chiara Lia Edo Bottacchi Adriana Brusa Luigi Sironi 《The journal of headache and pain》2003,4(3):164-167
Abstract
We describe the headache characteristics of two patients
with intracranial hypotension (IH) and correlate the magnetic
resonance imaging (MRI) pattern to the clinical aspects of this
type of headache. The first case was that of a patient with
spontaneous IH, whereas the second patient had IH following
rhinorrhoea. Cerebral computed tomography (CT) performed at
presentation of symptoms was normal in both patients. Cerebral
MRI in the first case showed meningeal contrast enhancement and
an MRI pattern consistent with a subdural hygroma, while in the
second case there was only a mild meningeal thickening. The
symptoms improved spontaneously in both cases in about 2–3
months, confirming that invasive manoeuvres are not mandatory in
these patients. 相似文献
12.
Once believed an exceedingly rare disorder, recent evidence suggests that low cerebrospinal fluid (CSF) pressure headache
has to be considered an important cause of new daily persistent headaches, particularly among young and middle-aged individuals.
Treatment of low CSF pressure headache consists of non-invasive/conservative measures and invasive measures with epidural
blood patch providing the cornerstone of the invasive measures. In the present pilot study we therefore aimed to evaluate
the treatment efficacy of epidural blood patch (EBP) in treatment-refractory low-pressure headache. Our primary effect parameter
was total headache burden defined as area under the curve (AUC: intensity × duration) and as secondary effect parameters we
identified: intensity (VAS 0-10), frequency (days per month), duration in hours (total hours/month) and also medication days
(days on medication/month). In our primary effect parameter we found a significant reduction in AUC with more than 25% and
this is considered to be clinically relevant. We found also a significant and relevant reduction at −22% in intensity. A trend
towards reduction in duration was seen. We found no statistically significant reduction in frequency. An increase in days
with use of medication was found. Increased awareness of low CSF pressure headache is emphasized and a controlled larger randomized
study is needed to confirm the results. However the present results, allows us to conclude that EBP in treatment-refractory
low CSF pressure headache can be considered as a treatment option. 相似文献
13.
14.
We report a case of intracranial hypotension caused by chiropractic manipulation which, in contrast to previously reported cases, documents the location of the cerebrospinal fluid leak by radionuclide cisternography. Cervical spinal manipulation produced a remote lumbar dural tear in our patient. Spinal magnetic resonance imaging may falsely localize the dural tear in this condition. Although conservative management is often sufficient, precise localization is required for more invasive therapies. 相似文献
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16.
Intracranial hypotension: the nonspecific nature of MRI findings 总被引:1,自引:0,他引:1
We present three patients who complained of postural headache related to different types of intracranial hypotension: spontaneous or primary, and secondary, but presenting the same findings on brain magnetic resonance imaging. Diffuse pachymeningeal gadolinium enhancement supports the belief that the enhancement is a nonspecific meningeal reaction to low pressure. 相似文献
17.
Spontaneous intracranial hypotension (SIH) is a well-defined clinical entity that is frequently misdiagnosed because little information regarding this type of headache exists in the Emergency Medicine literature. This report presents a case and relevant review of the literature on SIH. An understanding of the characteristic symptomatology, appropriate evaluation, treatment options, and prognosis is essential if the emergency physician is to provide the most appropriate care to these patients. 相似文献
18.
Porta-Etessam J Di Capua D Jorquera M Cuadrado ML Marcos A 《The journal of headache and pain》2011,12(1):109-111
Spontaneous intracranial hypotension (SIH) is a well-documented syndrome characterized typically by a benign, self-limited
course. Patients typically present with postural or exertional headaches that can be temporarily relieved by lying in a supine
or recumbent position. A 35-year-old Caucasian male suffered orthostatic headache that developed to a bilateral abducens palsy.
We ordered relative rest and the patient improved and completely recovered after 3 months. Although SIH is considered as a
benign and self limited process it could also be associated with disabling complications. We should be aware of the possible
complications and inform our patients. SIH can present with headache and bilateral abducens palsy even when the headache is
improving. 相似文献
19.
Dural rupture, cerebrospinal fluid leakage, and spontaneous intracranial hypotension may complicate significant or minimal spinal trauma and cause chronic headache with a positional component. While such cases typically reflect no pre-existing predilection, we encountered a patient whose cervicothoracic anatomy appeared to predispose him to this complication. 相似文献
20.
Spontaneous intracranial hypotension is an increasingly recognized disorder, often, although not always, characterized by the triad of low-opening cerebrospinal fluid pressure on lumbar puncture, postural headache, and diffuse parenchymal meningeal enhancement on magnetic resonance imaging of the head. We describe an unusual case of a patient with spontaneous intracranial hypotension presenting with postural headache and tinnitus, aggravated at high altitudes. 相似文献