隐藏的脊髓中枢液泄漏:修补或不修补 - - 一个基于病例的更新.
Jiashu Wang1, Amine P Thomé2, Allan L Brook3
1Albert Einstein College of Medicine, Bronx, NY, USA. jiashu.wang@einsteinmed.edu.
概括
儿童的隐性自发性内低血压 (oSIH),表现为正常的成像,可以通过经验性外周血补丁 (EBP) 成功治疗. 当保守措施失败时,这种方法可以显著缓解症状.
科学领域:
- 神经学 神经学
- 儿科 儿科 儿科
- 神经外科 神经外科
背景情况:
- 自发性内低血压 (SIH) 在儿童中很少见,其特点是由于脑脊液 (CSF) 泄漏而引起的静止性头痛.
- 怀疑SIH的正常大脑和脊柱成像是不常见的,导致诊断挑战.
- 成年人的隐性SIH (oSIH) 用经验外周血块 (EBP) 治疗,但没有报告儿科使用.
研究的目的:
- 报告第一个临床怀疑隐性SIH的儿科病例与正常成像.
- 评估经验性外周周血贴 (EBP) 在患有隐性SIH的儿科患者的疗效.
- 突出实证EBP作为一个潜在的治疗儿科oSIH当保守疗法失败时.
主要方法:
- 一个9岁女孩的病例报告,她患有严重的静止性头痛和正常的大脑/脊柱MRI.
- 用实证EBP治疗的SIH和oSIH病例的文献综述使用PubMed.
- 管理包括诊断oSIH和随后的经验性腰部EBP.
主要成果:
- 患者呈现出经典的SIH症状,但在多次MRI上没有异常.
- 以前对疑似病毒后综合征和偏头痛的治疗提供了最小的缓解.
- 经验性腰部EBP导致了深刻,完整和持续的症状解决.
结论:
- 经验外周周血贴 (EBP) 是对儿科隐性SIH (oSIH) 的可行和有效治疗方法.
- 在高临床怀疑儿科oSIH的情况下,尽管成像正常,但应考虑经验EBP.
- 经验EBP为小儿oSIH提供了较低的程序风险和显著的症状改善.
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