Spontaneous intracranial hypotension: case report with subdural hematomas, steroid dependency and clinical improvement after myelography.

J Platz, T Glücker, O Gratzl, M Woydt
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引用次数: 7

Abstract

Objective: In spontaneous intracranial hypotension (SIH), also known as spontaneous hypoliquorrhea, an abnormally low intracranial pressure leads to posture-dependent headaches similar to those observed after lumbar puncture. Although its etiology is not yet fully understood, it is now diagnosed more often as clinical awareness increases and the availability of MRI becomes more widespread.

Clinical presentation: We report the case of a 42-year-old patient with SIH who developed bilateral subdural hematomas (SDH) and symptomatic diencephalic herniation requiring surgical evacuation. Remarkably, he also developed partial pituitary insufficiency.

Therapy: After SDH was evacuated twice without success, his symptoms resolved rapidly after a diagnostic myelography.

Conclusion: Besides the orthostatic headache, the possible clinical manifestations are numerous. Serious complications and situations may occur that need to be recognized and treated. In addition to presentation of the case the literature to date is reviewed and discussed.

自发性颅内低血压:硬膜下血肿病例报告,类固醇依赖和脊髓造影后的临床改善。
目的:在自发性颅内低血压(SIH)中,也称为自发性痛经,异常低的颅内压导致姿势依赖性头痛,类似于腰椎穿刺后观察到的情况。虽然其病因尚不完全清楚,但随着临床意识的提高和核磁共振成像的普及,现在诊断得越来越多。临床表现:我们报告了一例42岁的SIH患者,他发展为双侧硬膜下血肿(SDH)和症状性间脑疝,需要手术清除。值得注意的是,他还出现了部分垂体功能不全。治疗:SDH两次抽吸均未成功,诊断性脊髓造影后症状迅速缓解。结论:除直立性头痛外,可能的临床表现多种多样。可能会出现严重的并发症和需要识别和治疗的情况。除了案例的介绍,文献到目前为止进行了回顾和讨论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Zentralblatt Fur Neurochirurgie
Zentralblatt Fur Neurochirurgie 医学-神经科学
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