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Spontaneous Intracranial Hypotension Associated with Simultaneous Rupture of Multiple Perineural Cysts

自發性顱內低壓合併多發性神經根周圍囊腫同時破裂

摘要


自發性顱內低壓一般多肇因於腦脊髓液滲漏,但影像學檢查卻不易發現滲漏點。我們報告一個因自發性顱內低壓而造成姿態性頭痛的病人,在她的脊髓攝影後電腦斷層造影檢查中,發現多發性神經根周圍囊腫在不同的胸腰椎位置同時破裂,造成對比劑漏出蛛網膜下腔外,也同時發現一些典型的顱內磁振造影表徵,包括瀰漫性腦膜顯影及腦部下降。腰椎硬腦膜外血液注射,可明顯改善她的臨床症狀及使顱內磁振造影表徵消失。

並列摘要


Cerebrospinal fluid (CSF) leakage is often considered as a cause of spontaneous intracranial hypotension (SIH) but are not commonly demonstrated radiographically. We report a patient with a 3-week severe postural headache due to SIH whose CT-myelogram showed simultaneous rupture of multiple perineural cysts at different levels of the thoracolumbar spine. Some typical MR pictures of the brain including diffuse meningeal enhancement and descent of the brain were also found. The signs and symptoms and MRI findings of the brain resolved after lumbar epidural blood patching injection.

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