自发性低颅压研究进展

betway必威登陆网址（betway.com ）学报››2022,Vol. 43››Issue (7): 544-547.DOI:10.3969/j.issn.2097-0005.2022.07.014

高晓玉¹(), 张颜波²()

^1.烟台毓璜顶医院神经内科，山东烟台 264000
^2.betway必威登陆网址第二附属医院神经内科，山东泰安 271000

收稿日期:2022-01-12出版日期:2022-07-25发布日期:2022-08-24
通讯作者:张颜波
作者简介:高晓玉，博士，副主任医师，主要从事脑血管病、头痛及头晕的研究，E-mail：xiaoyugao2017@outlook.com。
基金资助:
山东省自然科学基金(ZR2012HQ014);山东省医药卫生科技发展计划(2014WS0506);泰山医学院高层次课题培育计划(2016GCC02);烟台市重点研发计划（政策引导类）(2019NS139)

Research progress of spontaneous intracranial hypotension

Xiaoyu GAO¹(), Yanbo ZHANG²()

^1.Neurology Department，Yantai Yuhuangding Hospital，Yantai 264000，China
^2.Neurology Department，The Second Affiliated Hospital of Shandong First Medical University，Taian 271000，China

Received:2022-01-12Online:2022-07-25Published:2022-08-24
Contact:Yanbo ZHANG

摘要/Abstract

摘要：

自发性低颅压（spontaneous intracranial hypotension，SIH）通常由自发性脑脊液漏引起。典型表现为直立性头痛，但有些患者可有激素分泌异常、颅内静脉窦血栓形成、运动障碍、认知行为改变甚至昏迷等非典型表现，亦有部分患者颅内压正常。颅脑增强MRI表现为硬膜下积液、硬脑膜增强、静脉结构的充盈、垂体增大和大脑下垂。但与具有典型症状的SIH患者相比，非典型症状患者脑下垂的程度更严重。对于需要靶向硬膜外血贴治疗者，通过影像学检查定位脑脊液漏位置尤为重要。本文就SIH的非典型临床表现，脑脊液漏的定位、治疗等方面的进展作一综述。

关键词:自发性低颅压,非典型表现,脑脊液漏

Abstract:

Spontaneous intracranial hypotension is a well-recognized sequel of a spontaneous cerebrospinal fluid leak. But not all patients with spontaneous intracranial hypotension have typical orthostatic headache. The patients may have hormonal abnormalities， subdural fluid collections and subdural hematomas， cerebral venous thrombosis， movement disorders， cognitive behavioral changes， coma and other atypical manifestations， and some patients have normal brain pressure. Typical Gd-enhanced MRI features are subdural fluid collections， enhancement of pachymeninges， engorgement of venous structures， pituitary enlargement， and sagging of the brain. However， compared with SIH patients with typical symptoms， patients with atypical symptoms have more severe sagging of the brain. For those who need targeted epidural blood patch therapy， it is needed to localize cerebrospinal fluid leaks. This article reviews the atypicalclinical manifestations， location of cerebrospinal fluid leaks and treatment of spontaneous intracranial hypotension.

Key words:spontaneous intracranial hypotension,atypical presentation,cerebrospinal fluid leak

高晓玉, 张颜波. 自发性低颅压研究进展[J]. betway必威登陆网址（betway.com ）学报, 2022, 43(7): 544-547.

Xiaoyu GAO, Yanbo ZHANG. Research progress of spontaneous intracranial hypotension[J]. Journal of Shandong First Medical Unversity & Shandong Academy of Medical Sciences, 2022, 43(7): 544-547.

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