《中国康复理论与实践》

《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (12): 1178-1179.

• 临床观察 • 上一篇    下一篇

低颅压综合征21例临床分析

高乐虹   

  1. 首都医科大学宣武医院神经内科，北京市 100053
  • 收稿日期:2009-08-10 出版日期:2009-12-25 发布日期:2009-12-25

Retrospective Analysis of Intracranial Hypotension Syndrome: 21 Case Report

GAO Le-hong   

  1. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
  • Received:2009-08-10 Published:2009-12-25 Online:2009-12-25

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摘要： 目的 探讨低颅压综合征(IHS)的临床、脑脊液(CSF)和影像学特点及预后。方法 回顾性分析21例IHS患者的临床资料。结果 所有患者均有体位性头痛，并可伴随不同的症状；CSF压力均<70 mmH2O，白细胞计数(WBC)增多6例，红细胞计数(RBC)增多4例，蛋白升高10例；18例行头颅CT检查，15例正常，2例硬膜下血肿，1例硬膜下积液；18例行头颅磁共振成像(MRI)检查，5例正常，11例弥漫性硬脑膜增厚并强化，2例合并小脑扁桃体下疝；给予大量补液及对症支持治疗，效果良好。结论 体位性头痛是IHS的特征性症状，腰穿CSF及头颅MRI改变具有一定的特征，预后良好。

关键词: 低颅压综合征, 脑脊液, 影像学

Abstract: Objective To investigate the clinical, cerebrospinal fluid(CSF) and imaging characteristics of intracranial hypotension syndrome (IHS) and its prognosis.Methods The clinical information of 21 cases with IHS was retrospectively analyzed.Results All the 21 patients suffered orthostatic headache with different associated symptoms, low CSF pressure (<70 mmH2O). White blood cells count(WBC) in CSF increased in 6 patients, red blood cells count(RBC) increased in 4 patients, and protein in CSF is high in 10 patients. By cerebral CT, 15 out of 18 cases were normal, subdural hematoma in 2 cases, and subdural dropsy in 1 case. By cerebral MRI, 5 cases were normal, diffuse pachymeningeal thickening and enhancement in 11 cases, and amygdala cerebelli hernia in 2 cases. Large fluid infusion and supportive treatment resulted in good prognosis for them.Conclusion IHS typically presents with position headache, and CSF changes and MRI are of certain characteristic, usually following a good prognosis.

Key words: intracranial hypotension syndrome, cerebrospinal fluid, imaging