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.

Clinical analysis of 13 cases of spontaneous intracranial hypotension syndrome

Objective To study the clinical and imaging characteristics as well as cerebrospinal fluid chan-gea(CSF) of spontaneous intracranial hypotensian syndrome (SIHS).Methods The clinical characteristics, CSF and imaging data of 13 patients diagnosed as SIHS were retrospectively analyzed.Results All the 13 patients had orthostatic headache accompaning one or more numerous symptoms including nausea, vomiting, dizziness, diplopia and neck stiffness.All the patients had low CSF pressure,which was below 60 mm H2O and high CSF protein was in 5 patients, 8 had increased white cell counts and 9 had increased red cells counts;CT was performed in all patients.On CT scan the subdural effusion or small ventricles were compressed in 4 patients.MRI typically revealed diffused pachymeningeal enhancement in 2 patients;All the patients experienced relief of symptoms through conventional treatment.Conclusion Orthostatic headache is the most typical symptom in spontaneous intracranial hypotension syndrome and diffused pachymeuingeal enhancement is the most common imaging manifestation, and CSF hypovol-emia is the basis of pathophysiology of spontaneous intracranial hypotension syndrome.