低颅压综合征临床及影像特点分析

发布时间：2018-03-22 20:38

  本文选题：低颅压综合征　切入点：脑脊液压力　出处：《中国老年学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的探讨低颅压综合征的临床及影像学特点。方法回顾性分析2007年1月至2014年6月该院神经内科的14例低颅压综合征患者的临床资料,包括病史、神经系统体格检查、影像学特点、脑脊液检查和治疗预后。结果 14例患者多为急性或亚急性起病,临床表现为体位性头痛13例,神经系统体格检查有颈抵抗7例(合并克氏征阳性3例)。头CT平扫见脑室变小5例(合并脑肿胀3例),硬膜下积液1例,正常8例。头磁共振成像(MRI)平扫+增强+磁共振静脉成像(MRV)见弥漫性硬脑膜强化14例,累及颈段脊膜增厚强化5例,脑下垂10例,硬膜下积液7例,脑室脑池变小8例,垂体饱满、垂体柄显示不清4例。颅内静脉窦及脑静脉扩张7例。所有病例行颈椎MRI:颈椎轻度退变7例,正常7例。腰穿检查显示所有患者腰穿压力均60 mm H_2O。所有患者均口服补液或生理盐水静脉补液治疗,治疗后除1例患者出现硬膜下血肿转脑外科手术治疗外,其余患者均有不同程度好转。结论低颅压综合征临床表现为急性或亚急性起病的体位性头痛,脑脊液压力≤60 mm H_2O,结合特征性MRI表现有利于临床诊治。
[Abstract]:Objective to investigate the clinical and imaging features of intracranial hypotension syndrome. Methods the clinical data of 14 patients with hypobaric syndrome from January 2007 to June 2014 were analyzed retrospectively, including history and physical examination of nervous system. Results the 14 patients had acute or subacute onset and 13 patients had postural headache. There were 7 cases of cervical resistance (combined with Kirschner sign in 3 cases), 5 cases of cerebral ventricular small on plain CT scan (3 cases of brain swelling, 1 case of subdural effusion), 7 cases of cervical resistance (3 cases of brain swelling, 1 case of subdural effusion) on physical examination of nervous system. There were 14 cases of diffuse dural enhancement, 5 cases of cervical meningeal thickening, 10 cases of cerebral prolapse, 7 cases of subdural effusion, and 8 cases of ventricular cistern becoming smaller, the results showed that there were 14 cases of diffuse dural enhancement, 5 cases of cervical meningeal thickening, 10 cases of cerebral prolapse, 7 cases of subdural effusion, and 8 cases of ventricular cisterns becoming smaller. There were 4 cases with full pituitary gland, 4 cases with unclear pituitary stalk, 7 cases with intracranial venous sinus and cerebral vein dilatation. All cases were treated with cervical MRI: 7 cases with mild cervical degeneration, 7 cases with mild cervical degeneration. Lumbar puncture examination showed that the lumbar puncture pressure of all the patients was 60mm H _ 2O. All patients were treated with oral rehydration or saline intravenous rehydration, with the exception of one patient with subdural hematoma converted to cerebral surgery after treatment. Conclusion the clinical manifestations of intracranial hypotension syndrome are acute or subacute postural headache, cerebrospinal fluid pressure 鈮，

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