原发性低压综合征16例临床分析.docVIP

原发性低颅压综合征16例临床分析 　　[摘要] 目的 探讨原发性低颅压综合征的临床特点、诊断及治疗方法。 方法 回顾性分析我院2012年1月～2015年5月确诊的16例原发性低颅压综合征患者的临床表现、影像学资料、治疗情况及预后。 结果 16例患者均出现体位性头痛，可伴恶心、呕吐、头晕、听力下降、耳鸣、复视，面部麻木、视物模糊。头CT正常6例，硬膜下积液9例，硬膜下积血1例，脑室变窄2例。颅脑 MRI表现为硬脑膜弥漫强化12例、硬膜下积液10例、硬膜下积血3例，脑下沉6例，蛛网膜下腔出血1例，疑似颅内静脉窦血栓形成1例。腰穿脑脊液压力均低于60 mmH2O，可呈无色透明或淡红、淡黄色，可见白细胞、红细胞、蛋白含量不同程度升高。所有患者经保守治疗均好转出院，随访均痊愈。 结论 自发性低颅压综合征临床表现多种多样，体位性头痛、MRI弥漫性硬脑膜强化为其显著特点。保守疗法、自身血硬膜外注射法，手术治疗???方式是处理自发性低颅压综合征的有效手段。 中国论文网 /6/viewhtm 　　[关键词] 原发性低颅压；体位性头痛；临床表现多样化；硬脑膜强化 　　[中图分类号] R742 [文献标识码] B [文章编号] 1673-9701（2015）32-0038-03 　　[Abstract] Objective To investigate the clinical characteristics of primary intracranial hypotension syndrome， and it’s diagnosis ways and treatments. Methods A retrospective analysis of clinical manifestations imaging data， treatment and prognosis of 16 cases of patients who were confirmed primary intracranial hypotension syndrome in our hospital from January 2012 to May 2015 was conducted. Results Postural headache occurred in 16 cases of patients， accompanied by nausea， vomiting， dizziness， hearing loss， tinnitus， diplopia， facial numbness， blurred vision. There were six cases of patients with normal head CT， nine cases of subdural effusion patients， one case of subdural hemorrhage patients， and two cases of narrowed intraventricular patients. Brain MRI showed 12 cases of diffuse pachymeningeal enhancement patients， 10 cases of subdural effusion patients， 3 cases of subdural hematomas patients， 6 cases of brain sinking patients， one case of subarachnoid hemorrhage patients， and one case of suspected intracranial venous sinus thrombosis patients. Cerebrospinal fluid pressure was lower than 60 mmH2O， and the fluid was colorless transparent or pink， yellow， showing that the number of white blood cells， red blood cells and protein content increased at varying degrees. All patients improved and discharged after conservative treatment， and follow-up showed that they were cured. Conclusion Spontaneous intracranial hypotension