关键词：低颅内压；磁共振成像；脑脊髓液
【摘要 】 目的 研究自发性低颅内压综合征(SIH)的临床、脑脊液(CSF)和影像学的改变。方法 对1年8个月间收治的7例SIH患者观察其临床表现、CSF压力、生化指标及头颅CT和MRI增强扫描。结果 当患者起立时即出现头痛、呕吐及颈强直，卧位时症状消失。CSF压力均低于7cmH2 O。其中5例呈血性CSF，蛋白增高似蛛网膜下腔出血(SAH)。CT示脑室缩小。增强MRI示硬脑膜强化、硬脑膜下积液、桥脑扁平、桥池变窄及小脑扁桃体下疝的特征性改变。当临床症状好转时，其CSF压力和生化指标恢复正常。结论 了解SIH的临床、CSF和MRI表现至关重要，因其极易与SAH相混淆。
Spontaneous intracranialhypotension syndrome: 7 cases of reports
CHEN Shulan* , E Zijuan,LIU Yinghui, et al.
*Department of Neurology, First Clinical College, China Medical University, Shenyang 110001
【Abstract 】 Objective Tostudy the clinical features of spontaneous intracranial hypotension syndrome (SIH) and itscharacteristic changes in cerebrospinal fluid (CSF), CT and MRI. Methods 7cases of SIH patients, treated during the past 1 year and 8 months, were analyzed. Theirclinical manifestations were observed carefully, CSF pressure and biochemistry weremeasured and cranial CT, as well as MRI enhancement scannings were detected. Results Allthe patients had headache and vomiting on standing up and meningeal irritation signs werepositive. Their CSF pressures were<0 or below 7 cmH2 O. 5 cases had bloodyCSF with increased protein level, resembling subarachnoid hemorrage (SAH). The ventriclebecame small in CT and MRI demonstrated the features of diffuse pachymeningeal gadoliniumenhancement, evidence of descent of the brain (86%) that sometimes resembles type I Chiarimalformation, and subdural collections of fluid. Conclusions It isimportant to recognize the clinical manifestations of SIH, particularly the features ofCSF and MRI. In some cases, special attention is needed to differentiate with SAH to avoidmisdiagnosis.
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