自发性低颅压头痛患者26例预后因素分析

目的 探讨自发性低颅压头痛患者的临床特点及预后影响因素。方法 收集海军军医大学（第二军医大学）长海医院2010年至2017年诊治的符合国际头痛分类第3版（ICHD-3）自发性低颅压诊断标准的患者资料，分析患者年龄、性别、病程等一般临床特征以及脑脊液压力特征和影像学特征与自发性低颅压头痛预后的关系。结果 共纳入低颅压头痛患者26例，73.08%（19/26）患者治愈，26.92%（7/26）患者症状缓解。年龄、性别、病程、疼痛程度、头痛性质等临床特征及脑脊液压力对该病预后无影响。头颅磁共振成像提示硬脑膜强化、硬膜下积液、脑组织下垂等低颅压表现的13例患者中有12例（63.16%）治愈，1例（14.29%）缓解，差异有统计学意义（P=0.027）。结论 自发性低颅压头痛预后较好，影像学检查可以协助诊断，对疾病的预后有重要提示作用。

Prognostic factors in 26 patients with spontaneous intracranial hypotension

Objective To explore the clinical characteristics and prognostic factors of spontaneous intracranial hypotension (SIH) patients. Methods The clinical data of patients with SIH, who admitted to Changhai Hospital of Navy Medical University (Second Military Medical University) from 2010 to 2017 and met the SIH diagnostic criteria of international classification of headache disorders, 3^rd edition (ICHD-3), were collected. The effects of the general clinical features, such as gender, age and course of disease, and cerebrospinal fluid pressure and imaging features on prognosis of the SIH patients were analyzed. Results Of 26 SIH patients, 19 patients (73.08%) were cured and 7 patients (26.92%) were relieved. The gender, age, course of disease, severity of headache, headache types and cerebrospinal fluid pressure had no significant effect on the prognosis of the SIH patients. Among the 13 SIH patients with abnormal cranial magnetic resonance imaging findings, such as strenthening signals in cerebral dura, subdural fluid accumulation and brain sagging, 12 patients (63.16%) were cured and 1 (14.28%) was relieved, and the difference was significant (P=0.027). Conclusion SIH patients with headache have a good prognosis; imaging examination contributes to the diagnosis of SIH and may indicate the prognosis.