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目的探讨特发性低颅压综合征(SIHS)的临床特点、诊断及鉴别诊断。方法回顾性分析22例SIHS患者的临床表现、腰穿和头颅影像学特征。结果22例患者均有体位性头痛,卧位时缓解;脑脊液压力50～70mm H2O9例,20～50mm H2O6例,7例未测出。部分轻度白细胞增多和蛋白增高;20例行头颅MRI检查,其中14例显示脑膜强化。结论认识SIHS的临床特点、脑脊液变化和头颅MRI强化的特征,是诊断的关键。
Objective To investigate the clinical features, diagnosis and differential diagnosis of idiopathic intracranial hypotension syndrome (SIHS). Methods Retrospective analysis of 22 cases of SIHS patients with clinical manifestations, lumbar puncture and head imaging features. Results All 22 patients had positional headache and were relieved in supine position. Nine patients had cerebrospinal fluid pressure of 50-70 mm H2O, six patients had 20-50 mm H2O, and seven patients were not detected. Some mild leukocytosis and protein increased; 20 cases of skull MRI examination, of which 14 cases showed meningeal enhancement. Conclusion Understanding the clinical features of SIHS, cerebrospinal fluid changes and MRI features of the skull is the key to diagnosis.