CAJ | 학술논문

目的：分析原发性低颅压性头痛（SIH）的临床及影像特征，探讨其诊断及治疗。方法回顾分析17例 SIH 患者临床资料、诊断及治疗。结果17例患者均有典型体位性头痛和低颅压，脑脊液压力为0～60 mmH2 O，平均（38.22±24.85）mmH2 O。头颅 MRI 表现为脑组织下垂（41.18％）、硬膜下积液（11.76％）及硬脑膜强化（33.33％）；其中1例（占5.88％）合并有脑静脉窦血栓（CVST）形成。患者经卧床休息、补液、使用地塞米松等治疗全部治愈。结论典型的临床表现、低颅压及头颅 MRI 特点有助于SIH 的早期诊断；SIH 可能是导致 CVST 危险因素之一。
목적：분석원발성저로압성두통（SIH）적림상급영상특정，탐토기진단급치료。방법회고분석17례 SIH 환자림상자료、진단급치료。결과17례환자균유전형체위성두통화저로압，뇌척액압력위0～60 mmH2 O，평균（38.22±24.85）mmH2 O。두로 MRI 표현위뇌조직하수（41.18％）、경막하적액（11.76％）급경뇌막강화（33.33％）；기중1례（점5.88％）합병유뇌정맥두혈전（CVST）형성。환자경와상휴식、보액、사용지새미송등치료전부치유。결론전형적림상표현、저로압급두로 MRI 특점유조우SIH 적조기진단；SIH 가능시도치 CVST 위험인소지일。
Objective To analyze the features of clinical and neuroimaging of spontaneous intracranial hypotension(SIH)and ex-plore the diagnosis and treatment of it.Methods The clinical data,diagnosis and treatment of the 17 patients with SIH were retrospectively analyzed.Results Typical orthostatic headache,low cerebrospinal fluid(CSF)opening pressure were found in 17 cases.The CSF pressure of 17 cases was from 0 to 60(mean 38.22 ±24.85)mmH2 O.Brain magnetic resonance imaging(MRI)of the patients suffered from SIH showed sagging of the brain(41.18%),subdural fluid collections(11.76%)and diffuse pachymeningeal enhancement(33.33%).One case of them showed cerebral venous sinus thrombosis.All cases were cured after the treatment (bed rest,fluid infusion and dexamethasone ).Conclusion Typical orthostatic headache,low CSF opening pressure and brain MRI findings are helpful in identifying the early diagnosis of SIH.SIH may be one of the risk factors for CVST.