继发性低颅压综合征临床特征及治疗分析

目的分析继发性低颅压综合征的临床、影像学特征及治疗，提高对继发性低颅压综合征的认识。方法回顾性分析1例继发性低颅压征患者的临床资料，详细询问病史，常规及腰穿检查，阅读CT和MRI片，并行脊髓MRI水成像，给予硬膜外注射治疗。结果患者临床表现为体位性头痛伴恶心、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；脊髓MRI水成像精确显示CSF漏出点。于硬膜外腔注入生理盐水15ml治疗，头痛症状缓解。结论有低颅压表现及影像学特征的患者，应积极寻找低颅压的继发性原因，给予硬膜外注液治疗效果好。

Analysis of clinical characteristics and treatment of secondary intracranial hypotension

Objective To analyze the clinical and imaging characteristics and treatment of secondary intracranial hypo- tension syndrome（SIHS） so as to improve the understanding of secondary intracranial hypotension syndrome. Methods Clinical data of one patient with S1HS was retrospectively analyzed. Patients＇ history was inquired. And the normal check and lumbar puncture were administrated. The brain MRI and CT that had performed were given a radical review. The wa- ter image of spinal cord was performed. Epidural injection was given. Results The patients presented with symptoms of postural headache, nausea, vomiting; pressure of cerebrospinal fluid（CSF） couldn＇t be measured. Cranial MRI found typical subd~ral fluid collections, diffuse thickening of the pachymeninges with enhancement, engorgement of venous si- nuses, enlargementof the pituitax3＂ gland, and downward displacement of the brain. The water image of spinal cord pre- cisely located the site of CSF leak. Epidural infusion of normal saline relieved immediately the symptom of intracranial hypotension. Conclusions We should look for the cause of SIHS actively for those patients with dintracranial hypoten- sion and typical imaging characteristics. The treatment with epidural infusion for SIHS is very effectual.