貌似蛛网膜下腔出血的自发性低颅压综合征

目的探讨临床貌似蛛网膜下腔出血（SAH）的自发性低颅压综合征（SIH）患者的临床、脑脊液及影像学特征及鉴别要点。方法回顾性分析14例SIH住院病例，观察其临床表现、脑脊液压力、常规生化指标及头颅影像学特点。结果所有SIH病例均有直立性头痛，多数病人伴随有恶心等症状，可出现脑神经受累及脑膜刺激征，腰穿脑脊液均有不同程度的细胞数和蛋白增高，头颅MRI加强扫描有广泛脑膜强化。结论了解SIH临床、脑脊液及影像学特点对于鉴别SIH与SAH至关重要，直立性头痛、腰穿压力、病程、头颅MRI加强扫描等是鉴别SIH与SAH的有效方法。

Spontaneous intracranial hypotension clinically mimic subarachnoid hemorrhage

Objective To investigate different diagnosis feature from spontaneous intracranial hypotension(SIH)patients who clinically mimic subarachnoid hemorrhage(SAH).Methods 14 patients with headache related to the syndrome of SIH were investigated.The clinical representation, cerebrospinal fluid and MRI changes were observed.Results All the patients were characteristic of postural headache.They also have meningeal irritation signs.Most of their cerebrospinal fluid had blood cell and protein increased.All of the 6 cases with gadolinium enhancement scan had positive results. Conclusion It is important to recognized the representation of SIH syndrome,especially changing in the features ofcerebrospinal fluid,MRI gadolinium enhancement scanning is much help to make different diagnosis from SAH.