自发的内低血压模仿iatrogenic脊髓脑脊髓液泄漏
Angelique Sao-Mai S Tay1, Marcel M Maya2, Wouter I Schievink1
1Department of Neurosurgery, Cedars Sinai Medical Center, Los Angeles, California, USA.
Headache
|September 2, 2024
概括
在脊柱手术后持续的头痛可能表明自发的脑脊液 (CSF) 泄漏. 早期评估CSF泄漏至关重要,即使是正常的大脑MRI发现.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 放射学 放射学是指放射学
背景情况:
- 在轻微的创伤后,自发的内低血压 (SIH) 可能会出现.
- 在脊椎手术后的脊髓脑脊液 (CSF) 泄漏可以模仿阳性泄漏.
- 在这些情况下,诊断混是常见的.
研究的目的:
- 突出考虑在脊髓后手术后患有持续头痛的患者中自发性CSF泄漏的重要性.
- 为了区分自发的脊髓脊髓液泄漏与阳性性泄漏.
主要方法:
- 对SIH患者进行了回顾性队列研究.
- 对从2022年1月到2023年6月的前性维护数据库进行分析.
- 鉴定因阳性泄漏而转诊但被诊断为自发泄漏的患者.
主要成果:
- 在248名 (4%) 的SIH患者中,最初有9名因阳性泄漏而被转诊.
- 程序包括外围注射,细叶切除术,外围麻醉和腰部穿刺.
- 自发泄漏位于手术地点至少五层;78%的人在脑MRI上显示内低血压.
结论:
- 在脊椎手术后患有持续性静止性头痛的患者中怀疑自发性脊髓中枢液泄漏.
- 考虑自发泄漏,即使在手术后不久出现症状.
- 在术后头痛的背景下,异常的大脑MRI发现需要进一步调查自发性CSF泄漏.
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