Spontaneous Intracranial Hypotension : Clinical Presentation, Imaging Features and Treatment
박은수, 김일만,
소속 상세정보
박은수 ( Park Eun-Soo )
계명대학교 의과대학 동산의료원 신경외과학교실
김일만 ( Kim Eal-Maan )
계명대학교 의과대학 동산의료원 신경외과학교실
KMID : 1001920090450010001
Abstract
Objective : In the present study, the authors investigated the clinical and imaging features as well as the therapeutic outcomes of SIH (spontaneous intracranial hypotension) patients.
Methods : A retrospective review of 12 SIH patients was carried out. The diagnostic work-up included lumbar tapping and measurement of CSF opening pressure, radioisotope cisternography, brain and spinal magnetic resonance imaging (MRI), and computed tomography (CT) myelography. Autologous epidural blood patching was performed in patients who did not respond to conservative therapies, including analgesics, steroids, hydration and rest.
Results : Typical postural headache was found in 11 (91%) patients. Nine (75%) patients showed pachymeningeal enhancement on their initial T1-weighted MR images. The CSF opening pressure was less than 60 mmH2O in 9 of 11 patients. Autologous epidural blood patching was performed in 7 patients, and all of them showed good responses.
Conclusion : SIH can present with various clinical presentations and neuroimaging findings. Autologous epidural blood patching is thought to be the treatment of choice for patients with SIH.
키워드
Headache;Cerebrospinal fluid leak;Dural enhancement;Magnetic resonance imaging;Blood patch;Intracranial hypotension
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