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題名 | Spontaneous Intracranial Hypotension in a Patient with Reversible Pachymeningeal Enhancement and Brain Descent=原發性顱內低壓症--可逆性硬腦膜顯影增強與腦降之磁振造影表現 |
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作者 | 曾昱龍; 張永義; 藍旻瑜; 吳秀善; 劉家壽; | 書刊名 | 長庚醫學 |
卷期 | 26:4 2003.04[民92.04] |
頁次 | 頁293-298 |
分類號 | 415.9 |
關鍵詞 | 低顱內壓症候群; 姿勢性頭痛; 腦脊髓液; 磁振造影; Intracranial hypotension; Orthostatic headache; Cerebrospinal fluid; Magnetic resonance imaging; |
語文 | 英文(English) |
中文摘要 | 一位56歲的女性,因嚴重的姿勢性頭痛合噁心嘔吐前來求診,腰椎穿刺檢查發腦脊髓液壓明顯下降,臨床上診斷為低顱內壓症候群。第一次的腦部磁振造影發現廣泛性的腦膜顯影以及腦部下墜,然放射性同位素腦池攝影未能發現明顯的脊髓液滲漏。患者的頭痛經兩週治療後已完全恢復,但兩個月後追蹤的腦部磁振造影發現腦膜顯影僅有部分改善,直到6個月後才完全消失。由此可見罹患自發性低顱內壓症候群之患者,其腦膜顯影的現象是可逆性的,我們推論此種延遲性腦膜顯影消失的變化可能與腦膜的增生有關。 |
英文摘要 | A 56-year-old woman presented with severe orthostatic headache in association with nausea and vomiting. Lumbar puncture for the patient revealed significantly low cerebrospinal fluid pressure (CSF) and the clinical diagnosis of intracranial hypotension syndrome was made. An initial gadolinium-enhanced brain magnetic resonance imaging (MRI) disclosed diffuse meningeal enhancement as well as brain sagging. No definite CSF leakage was found using radionuclide cisternography. Her headaches abated with proper usage of analgesics, strict bed rest, and intravenous hydration. Follow-up neuroimaging studies showed partially resolved meningeal enhancement 2 months after treatment and complete resolution 6 months after treatment. The temporal changes found on MRI suggest that the pachymeningeal enhancement is reversible in patients with spontaneous intracreanial hypotension. Moreover, proliferation of meninges is likely to be responsible for this type of delayed resolution phenomenon. |
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