本文選題：低顱壓綜合征　切入點：腦脊液壓力　出處：《中國老年學(xué)雜志》2017年02期 　論文類型：期刊論文

【摘要】：目的探討低顱壓綜合征的臨床及影像學(xué)特點。方法回顧性分析2007年1月至2014年6月該院神經(jīng)內(nèi)科的14例低顱壓綜合征患者的臨床資料,包括病史、神經(jīng)系統(tǒng)體格檢查、影像學(xué)特點、腦脊液檢查和治療預(yù)后。結(jié)果 14例患者多為急性或亞急性起病,臨床表現(xiàn)為體位性頭痛13例,神經(jīng)系統(tǒng)體格檢查有頸抵抗7例(合并克氏征陽性3例)。頭CT平掃見腦室變小5例(合并腦腫脹3例),硬膜下積液1例,正常8例。頭磁共振成像(MRI)平掃+增強+磁共振靜脈成像(MRV)見彌漫性硬腦膜強化14例,累及頸段脊膜增厚強化5例,腦下垂10例,硬膜下積液7例,腦室腦池變小8例,垂體飽滿、垂體柄顯示不清4例。顱內(nèi)靜脈竇及腦靜脈擴張7例。所有病例行頸椎MRI:頸椎輕度退變7例,正常7例。腰穿檢查顯示所有患者腰穿壓力均60 mm H_2O。所有患者均口服補液或生理鹽水靜脈補液治療,治療后除1例患者出現(xiàn)硬膜下血腫轉(zhuǎn)腦外科手術(shù)治療外,其余患者均有不同程度好轉(zhuǎn)。結(jié)論低顱壓綜合征臨床表現(xiàn)為急性或亞急性起病的體位性頭痛,腦脊液壓力≤60 mm H_2O,結(jié)合特征性MRI表現(xiàn)有利于臨床診治。
[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，

本文編號：1650285