低颅压综合征21例临床分析

分析自发性低颅压与继发性低颅压的差异。对10例自发性低颅压与11例继发性低颅压在病因、脑脊液、影像学方面进行回顾性分析与比较。结果自发性低颅压者经治疗后临床表现消失，脑脊液恢复正常，预后良好；继发性低颅压综合征病因相对明确。血性脑脊液发生率较低。影像学易确诊，治疗及预后随原发病而定。     

低颅压综合征21例临床分析

目的探讨低颅压综合征（IHS）的临床、脑脊液（CSF）和影像学特点及预后。方法回顾性分析21例IHS患者的临床资料。结果所有患者均有体位性头痛,并可伴随不同的症状;CSF压力均〈70mmH2O,白细胞计数（WBC）增多6例,红细胞计数（RBC）增多4例,蛋白升高10例;18例行头颅CT检查,15例正常,2例硬膜下血肿,1例硬膜下积液;18例行头颅磁共振成像（MRI）检查,5例正常,11例弥漫性硬脑膜增厚并强化,2例合并小脑扁桃体下疝;给予大量补液及对症支持治疗,效果良好。结论体位性头痛是IHS的特征性症状,腰穿CSF及头颅MRI改变具有一定的特征,预后良好。     

低颅压综合征25例临床分析

低颅压综合征临床较少见,容易误诊,现收集昆明医学院第一附属医院1980～1991年临床确诊的14例及我科近5年来收治的11例,共25例分析如下。     

原发性低颅压综合征13例临床分析

目的 探讨原发性低颅压综合征的临床表现、脑脊液和影像学特点.方法 回顾分析13例临床诊断明确的原发性低颅压综合征患者的临床表现、脑脊液及影像资料.结果 所有患者均有体位性头痛,并可伴有恶心、呕吐、头晕、复视及颈强直;CSF压力均<60 mm H2O,蛋白升高5例、白细胞增多8例、红细胞增多9例;均行头CT检查,4例分别出现硬膜下积液和脑室变小;2例头颅MRI增强检查示弥漫性硬脑膜强化;均采用保守治疗,均痊愈.结论 体位性头痛是原发性低颅压综合征最典型的临床症状,硬脑膜弥漫性强化是最常见的影像学表现,CSF容量减少是原发性低颅压综合征临床及影像学表现的病理生理基础.     

原发性低颅压综合征22例临床分析

目的探讨原发性低颅压综合征（primary intracranial hypotension,PIH）的临床特点、影像学特征及预后,提高对该病的认识和诊治水平。方法回顾性分析22例PIH患者的临床资料。结果 22例患者均有与体位相关的头痛;脑脊液压力均小于70 mmH2O,血性脑脊液3例,红细胞增高6例,白细胞增高3例,蛋白增高7例;14例行头颅CT平扫,12例正常,1例双侧硬膜下积液,1例双侧额颞部慢性硬膜下血肿;11例行头颅MRI检查,其中6例MRI增强扫描示硬脑膜弥漫性强化和增厚;22例均经内科保守治疗痊愈。结论体位性头痛是原发性低颅压综合征的临床特征,腰穿脑脊液及头颅MRI增强扫描检查具有诊断价值,本病一般预后良好。     

原发性低颅压综合征18例临床分析

原发性抵依压综合征（PIH）系指侧卧位时腰穿压力低于0．686kPa以下,病因不明的一种疾病。临床较少见。我院1985～互997年共收治18例,报告如下。1临历资料1．且一般资料18例中男6冽,女12冽;年龄12～54岁,平均34岁。长期失眠4例,低血压3例,有高血压病及颈椎病史各2例,晕厥史1例。急性起病6例,缓慢起病12例。发病到获论时间6～65天,平均18．5天。1．Zk床表现首发症状均为头痛,于坐位或站立时加重,平卧位减轻,其中铁顶部跳痛7例,全头胀痛6例,枕颈部钝好5例,伴呕吐11例,视物不清5例,眩晕《例。脑膜刺激征阳性6例,均无意识…     

原发性低颅压综合征21例临床分析

目的探讨原发性低颅压综合征的发病机制、临床特点及诊断问题。方法回顾性分析21例原发性低颅压综合征患者的临床资料。结果所有患者均有头痛,且头痛与体位密切相关,坐位或站位时头痛加重,平卧位时头痛减轻或消失,头痛部位位于枕部8例,额部3例,顶部4例,全头痛6例;伴随症状有恶心、呕吐15例,眩晕10例,耳鸣6例,视物模糊3例,听力下降2例;体征有颈项强直10例,病理征阳性3例。经综合治疗5～15 d全部患者均痊愈出院。结论原发性低颅压综合征原因不明确,临床特征为体位性头痛,脑脊液压力〈60 mm H2O可诊断,临床医师认识不够易造成误诊。     

低颅压综合征10例临床分析

低颅压综合征临床较少见,好发年龄30~49岁,以女性居多,病程数日至数月不等[1]。我院2003年2月~2007年2月共收治低颅压综合征10例,现将治疗体会报告如下。1临床资料1·1一般资料本组男3例,女7例;年龄20~61岁,平均39岁;病程2~50天,平均18天。有明确病因2例,其中1例因头痛、恶心、呕吐行腰穿脑脊液(CSF)检查,按病毒性脑炎予脱水治疗,1例有脊髓手术史;余8例无明确病因。本组均为首次发病,其中3例误诊,分别诊断为病毒性脑炎、蛛网膜下腔出血(SAH)及颈椎病。1·2临床表现本组急性起病5例,亚急性起病3例,慢性起病2例。均有与体位关系密切的头痛…     

自发性低颅压综合征4例误诊分析

自发性低颅压综合征 (SIH)是指原因不明 ,预后良好 ,颅压低于 70mmH2 O的一组少见征候群 ,临床以起立时剧烈头痛、呕吐及颈部强直为主要表现 ,当平卧时头痛很快消失或减轻为特征[1] 。由于临床较为少见 ,故极易造成误诊。现将我院 1999年 6月～ 2 0 0 1年 7月误诊的 4例SIH报道如下。1　临床资料1.1　一般资料　男 1例 ,女 3例 ;年龄 2 4～ 4 3岁 ,平均 36 .2岁。均为急性起病 ,病程 5～ 2 4天 ,平均 13.5天。除外颅脑损伤、开颅术、分流术 ,无脑脊液漏 ,病前无腰椎穿刺以及糖尿病与尿毒症史。1.2　临床表现　均表现为剧烈头痛、恶心、…     

武警战士原发性低颅压综合征12例临床分析

我院自 1988～ 2 0 0 0年共收治武警战士原发性低颅压综合征患者 12例 ,本文对其发病原因分析如下。1　临床资料1.1　一般资料　本组 12例 ,均为男性 ,年龄 19～ 2 2岁。其中新战士 2例 ,老战士 10例。1.2　病因及起病时间　 2例新战士分别在 12月和 1月 ,10例老战士在 5～ 6月起病。 12例均无颅脑外伤及手术史 ,无脊柱外伤及腰穿史。1.3　临床表现　主要表现为进行性加剧与体位相关的头痛。起病为亚急性 ,就诊时间为发病后 7～ 10天 ,平均 9天。头痛的主要特征是体位性头痛 ,即直立时加重 ,咳嗽、喷嚏、用力、震动时亦加剧 ,平卧时减轻 ;头…     

Isolated Cortical Venous Thrombosis Associated With Intracranial Hypotension Syndrome

The association of intracranial hypotension syndrome with cerebral venous thrombosis is rare. We report our experience with isolated cortical venous thrombosis, which developed after unsuccessful epidural anesthesia. Magnetic resonance imaging showed characteristic imaging findings of intracranial hypotension syndrome, such as dural thickening and brain sagging. We also detected right parietal venous hemorrhagic infarction secondary to right-sided cortical venous thrombosis. After the treatment of intracranial hypotension via epidural blood patch, heparin was used to treat cortical venous thrombosis.     

Cerebral Venous Thrombosis in Spontaneous Intracranial Hypotension

Background and Objective.— The occurrence of cerebral venous thrombosis has been reported among patients with spontaneous intracranial hypotension, but a causal relationship has not been clearly established. We reviewed our experience with spontaneous intracranial hypotension and cerebral venous thrombosis and we reviewed the relevant literature to evaluate the relationship between these 2 entities. Methods.— We reviewed the medical records and imaging studies of a consecutive group of patients with spontaneous intracranial hypotension evaluated at a tertiary care center between 1/1/2001 and 12/31/2007. The main search strategy was a systemic review of journal articles in MEDLINE (1966 to January 2008). Results.— Among 141 patients with spontaneous intracranial hypotension, 3 (2.1%) were also diagnosed with cerebral venous thrombosis. Among these 3 patients and the 17 reported in the literature there were 11 men and 9 women with a mean age of 39.5 years. Radiographic or clinical evidence for spontaneous intracranial hypotension preceding cerebral venous thrombosis was found in most patients, while there was no evidence for cerebral venous thrombosis preceding spontaneous intracranial hypotension in any patient. Eight (40%) of the 20 patients were found to have a change in their headache pattern believed to be due to the development of cerebral venous thrombosis. Complications of cerebral venous thrombosis, eg, cerebral venous infarction, occurred in 8 patients (40%). Conclusions.— Spontaneous intracranial hypotension is a risk factor for cerebral venous thrombosis, but cerebral venous thrombosis is found in only about 2% of patients with spontaneous intracranial hypotension. A change in headache pattern is not a reliable predictor of the development of cerebral venous thrombosis in patients with spontaneous intracranial hypotension.     

婴儿良性部分性癫痫35例临床分析

目的:研究婴儿良性部分性癫痫的临床特点及治疗反应,探讨早期诊断方法。方法:对生后24个月内起病、排除热性惊厥、症状性癫痫、发育异常的婴儿惊厥进行临床及脑电观察,并随访治疗和预后。结果:35例患者7例惊厥伴轻度胃肠炎,5例有良性婴儿惊厥家族史,29例有丛集性发作,14例VEEG监测证实分别为起源于颞、枕、额、顶区的部分性发作。发作间期脑电图无异常。所有病例均接受抗癫痫单药治疗,5例失访。30例平均用药时间8.1个月,29例于服药6个月内发作消失,停药后3例复发,随访期内未见2岁后再复发者,21例随访至2岁以上确诊为婴儿良性部分性癫痫。结论:起病早期有以下特点应考虑婴儿良性部分性癫痫可能:①首发年龄1岁以内,不超过2岁;②复杂部分性发作或复杂部分性发作伴泛化;③呈丛集性发作,但无癫痫持续状态;④无神经系统基础病,发作无明显诱因;⑤起病前精神运动发育正常,神经影像检查正常;⑥可有婴儿良性惊厥家族史;⑦发作间期脑电图无异常,发作期有痫样放电。     

Iatrogenic Intracranial Hypotension: A Case Study

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.     

Caring for Patients With Spontaneous Intracranial Hypotension

Spontaneous intracranial hypotension (SIH) is a form of intracranial hypotension that often lacks uniformity in its presentation on physical assessment and radiological imaging studies among patients. SIH can be mistaken for a number of other unrelated conditions, and because it is also quite rare, many health care providers and patients are not familiar with this condition. These factors make SIH difficult to recognize and diagnose. This article seeks to bring greater awareness to health care professionals about SIH to direct patients affected by SIH to more appropriate and timely care. This work also offers suggestions for management of patients receiving an epidural blood patch, a common treatment for SIH.