自发性颅内低血压1例硬膜外补血后早期和延迟反弹性颅内高压

IF 0.9 Q4 CLINICAL NEUROLOGY
E. Jafari, M. Karaminia, M. Togha
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引用次数: 4

摘要

自发性颅内低血压(SIH)是一种继发性头痛,已归因于脑脊液(CSF)泄漏。它可以自行消退或需要保守治疗。硬膜外血贴片(EBP)与自体血液进行的情况下,表现出不充分的反应保守方法。反弹性颅内高压(RIH)可在高达27%的患者发生EBP后发生。其特点是头痛特征的改变,并常伴有恶心、视力模糊和复视。症状通常在最初的36小时内开始,但可能在几天到几周内发展。重要的是要区分这种反弹现象和未改善的SIH,因为治疗方案不同。案例演示。在这里,我们报告了一个有趣的病例,SIH患者接受EBP治疗,在EBP后24小时发生立即RIH,并在EBP后3周发生延迟RIH。结论EBP治疗SIH后,新发不同类型和部位的头痛应始终监测RIH的发生。如果脑脊液压力升高的症状变得无法忍受或诊断不确定,则应进行腰椎穿刺。缺乏早期诊断、治疗和鉴别可引起并发症,并可能影响视神经。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early and Delayed Rebound Intracranial Hypertension following Epidural Blood Patch in a Case of Spontaneous Intracranial Hypotension
Background Spontaneous intracranial hypotension (SIH) is a secondary headache that has been attributed to a cerebrospinal fluid (CSF) leak. It may resolve spontaneously or require conservative treatment. An epidural blood patch (EBP) with autologous blood is performed in cases exhibiting an inadequate response to conservative methods. Rebound intracranial hypertension (RIH) can develop following an EBP in up to 27% of patients. It is characterized by a change in the headache features and is often accompanied by nausea, blurred vision, and diplopia. Symptoms commonly begin within the first 36 hours, but could develop over days to weeks. It is important to differentiate this rebound phenomenon from unimproved SIH, as the treatment options differ. Case Presentation. Here, we present an interesting case of a patient with SIH who was treated with EBP and developed both immediate RIH after 24 hours and delayed RIH 3 weeks following EBP. Conclusions Following EBP for treatment of SIH, new onset of headache having a different pattern and location should always be monitored for the occurrence of RIH. A lumbar puncture should be done if the symptoms of elevated CSF pressure become intolerable or if the diagnosis is uncertain. Lack of early diagnosis and treatment and differentiation from SIH can cause complications and could affect the optic nerves.
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11 weeks
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