【摘要】 目的总结自发性或继发性低颅压综合征（intracranial hypotension syndrome,IHS）患者的临床特点。方法 回顾性分析2022年9月至2023年5月我院诊断为自发性或继发性IHS的患者，收集临床资料，总结影像学特点、治疗方式以及预后。结果 共入组30例，自发性和继发性IHS患者占比分别为63%(19例)和37%(11例)。临床特征上，直立性头痛最为常见（29例，96.7%），最常累及枕部（12例，40.0%），其次是额顶部（9例，30.0%）；头颅影像学特征中，硬脑膜强化出现率最高（17例，56.7%）。CT脊髓造影显示，脑脊液漏最常见的位置是脊柱颈段（10例）和上胸段（9例），其次是下胸段（4例）和腰段（4例）。经保守治疗和靶向硬膜外血贴手术治疗，患者总有效率90%。结论 直立性头痛和头颅MRI“硬脑膜强化”对于IHS的定性诊断有强提示作用，CT脊髓造影有助于脑脊液漏点的精确定位，靶向硬膜外血贴治疗是保守治疗无效时治愈IHS的有效方法。更多还原

【Abstract】 Objective To analyze and summarize the clinical presentation of spontaneous and secondary intracranial hypotension syndrome(IHS). Methods Patients diagnosed with spontaneous or secondary IHS from September 2022 to May 2023 were retrospectively analyzed. The clinical data, imaging features, treatment methods and prognosis were collected. The correlation between intracranial pressure values and clinical characteristics of the patients was statistically analyzed. Results A total of 30 patients were enrolled, and the proportion of spontaneous and secondary IHS was 63%(19 cases) and 37%(11 cases), respectively. In terms of clinical features, orthostatic headache was the most common type(29 cases, 96.7%) and most commonly involved occipital region(12 cases, 40.0%), followed by frontoparietal region(9 cases, 30.0%). Among the brain imaging features, dural enhancement was the most common(17cases, 56.7%). According to CT angiography of spinal cord findings, cerebrospinal fluid leakage is one of the most common location of cervical spine segments(10 cases), and on the thoracic segments(9 cases), followed by the thoracic segments(4cases) and lumbar segments(4 cases). After conservative treatment and surgical treatment, the total effective rate was 90%. Conclusion Orthostatic headache and cranial MRI "dural enhancement" have strong indication on the definitive diagnosis of IHS. CT myelography is helpful to precisely localize the site of cerebrospinal fluid leakage. Targeted epidural blood patch therapy is an effective method to cure IHS when conservative treatment is ineffective.更多还原