自发性低颅压症的影像学特征及硬膜外注液治疗的效果(附1例报告)

目的研究自发性低颅压症(SIH)的影像学特征及硬膜外注液治疗的效果。方法回顾性分析1例SIH患者的临床资料。结果本例患者临床表现体位性头痛伴恶心、呕吐,腰穿脑脊液(CSF)压力测不出。头颅MRI显示有典型的硬膜下积液、硬脑膜的弥漫性增强、静脉窦充血扩张、垂体充血增大、脑组织下移。高分辨率CT脊髓造影精确显示CSF漏出点。于硬膜外腔注入生理盐水15ml治疗,头痛症状缓解。结论SIH的影像学特征为静脉窦扩张、硬脑脊膜强化、硬膜下腔积液;硬膜外注液治疗的效果好。

Imaging characteristics of spontaneous intracranial hypotension and the effect of epidural infusion treatment (report of a case )

Objective Study the imaging characteristics of spontaneous intracranial hypotension(SIH) and the effect of epidural infusion treatment.Methods Clinical data of one patient with SIH was retrospective analysis.Results The patient presented with symptoms of postural headache,nausea,vomiting;pressure of cerebrospinal fluid(CSF) couldn't be measured.Cranial MRI found typical subdural fluid collections,diffuse thickening of the pachymeninges with enhancement,engorgement of venous sinuses,enlargement of the pituitary gland,and downward displacement of the brain.High-resolution CT myelography precisely located the site of CSF leak.Epidural infusion of normal saline relieved immediately the symptom of intracranial hypotension.Conclusions The imaging characteristics of SIH includes engorgement of venous sinuses,diffuse thickening of the pachymeninges with Gd enhancement,subdural fluid collections.The treatment with epidural infusion for SIH is very effectual.