低髄液圧症候群診断の混乱について

DOI Web Site 参考文献20件
  • 土居 浩
    財団法人東京都保健医療公社荏原病院脳神経外科
  • 中村 精紀
    財団法人東京都保健医療公社荏原病院脳神経外科
  • 望月 由武人
    財団法人東京都保健医療公社荏原病院脳神経外科
  • 徳永 仁
    財団法人東京都保健医療公社荏原病院脳神経外科
  • 吉田 陽一
    財団法人東京都保健医療公社荏原病院脳神経外科
  • 大橋 元一郎
    財団法人東京都保健医療公社荏原病院脳神経外科
  • 井田 正博
    財団法人東京都保健医療公社荏原病院放射線科

書誌事項

タイトル別名
  • The Diagnosis of Cerebrospinal Fluid Leak in Intracranial Hypotension

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<p>  Spontaneous spinal cerebrospinal fluid (CSF) leaks are an increasingly recognized cause of intracranial hypotension. Comprehensive diagnostic criteria encompassing the varied clinical and radiographic manifestations of spontaneous intracranial hypotension are not available. In this report the authors review the diagnosis of the point of cerebrospinal fluid leak. The major presenting symptoms include postural headaches, nausea, vomiting, and diplopia. Often, there is no history of traumatic injury. The most common cranial magnetic resonance (MR) imaging features include pachymeningeal gadolinium enhancement. MR myelography is a non invasive method to detect CSF leakage, however, extradural hyperintensity on MR myelography is non-specific for CSF. Fat-saturated T2-weighted imaging and post contrast T1-weighted imaging should be added to confirm CSF leakage. On spinal MR images, meningeal cysts and extradural venous plexus are frequently misdiagnosed as CSF leakage. In cases in which symptoms are severe and refractory to less invasive measures, surgical intervention is indicated. Recently, some authors reported the identification of upper cervical epidural fluid collections as a false localizing sign in patients with spontaneous intracranial hypotension (SIH) and this has provided significant insight into the selection of management options. However, herein we report on true C1-2 CSF leakage. We examined a group of consecutive patients with 25 SIH and 13 posttraumatic CSF hypovolemia and investigated clinical, MRI, CT myelography, and radioisotope findings and therapeutic outcomes of this syndrome.</p>

収録刊行物

  • 脊髄外科

    脊髄外科 23 (2), 211-217, 2009

    日本脊髄外科学会

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