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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.

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

|December 21, 2025

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.

关键词:

案例报告案例报告大脑脊髓液泄漏脑脊液泄漏 epidural 血液贴片在外周外注血.儿科儿科儿科自发的内低血压.

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