Spontaneous intracranial hypotension caused by high-flow spinal cerebrospinal fluid leaks: analysis of 6 patients
10.3760/cma.j.cn113694-20220505-00360
- VernacularTitle:高流量硬脊膜脑脊液漏致自发性低颅压6例临床分析
- Author:
Yanfang DAI
1
;
Zhen WANG
;
Zheng WANG
;
Tengda LIU
;
Kang WANG
;
Chong SHEN
;
Yan LI
;
Jie WU
;
Dezhou QI
;
Tianxinyu XIA
;
Hong YE
;
Junjie LI
;
Liyong WU
Author Information
1. 首都医科大学宣武医院放射与核医学科，北京100053
- Keywords:
Intracranial hypotension, spontaneous;
Spinal cerebrospinal fluid leaks;
High-flow;
Targeted epidural blood patch
- From:
Chinese Journal of Neurology
2023;56(2):178-186
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical features of 6 patients with spontaneous intracranial hypotension caused by high-flow spinal cerebrospinal fluid leaks.Methods:The clinical characteristics, auxiliary examinations, treatment, and outcomes in 6 patients of spontaneous intracranial hypotension caused by high-flow spinal cerebrospinal fluid leaks enrolled in the Xuanwu Hospital, Capital Medical University from February 2021 to April 2022 were retrospectively reviewed.Results:All the 6 patients had orthostatic headaches. Brain magnetic resonance imaging showed dural enhancement and brain sagging and magnetic resonance myelography showed longitudinal extradural collection in all the patients. The high-flow spinal cerebrospinal fluid leaks were demonstrated in upper thoracic segments by the dynamic myelography. The headache disappeared after conservative treatment in 2 patients and treatment with targeted epidural blood patch in 4 patients.Conclusions:The diagnosis of spontaneous intracranial hypotension caused by high-flow spinal cerebrospinal fluid leaks with typical orthostatic headache and brain magnetic resonance imaging and myelography findings is not difficult. However, the localization of the site of high-flow spinal cerebrospinal fluid leaks in spontaneous intracranial hypotension depends on the dynamic myelography. Targeted epidural blood patch is effective, but conservative treatment does not always work.
