Clinical Analysis Of Spontaneous Intracranial Hypotension

Background： Pathophysiological basis of spontaneous intracranialhypotension is cerebrospinal fluid reducing, and cerebrospinal fluid pressurereduced. Pathogenesis is still not clear,but the primary and potential ofcerebrospinal fluid leakage are considered close relationship with it. Thedisease prognosis is good. Early diagnosis and early treatment is to prevent andcure the disease complications of the key.Objective:To investigate and analyze the spontaneous intracranialhypotension.Methods:The clinical data of57cases of spontaneous intracranialhypotension were retrospectively analyzed, and compared with the domesticand foreign relevant material.Results:All patients were from18to57years old with the mean age of36.79,and the ration of males and females was1:1.375. Before the onset,3（5.26%）patients had vigorous exercise or hard physical labor history,7（12.28%）patients had vomiting, diarrhea or perspire history,9（15.79%）patients had influenza history,5（8.77%）patients had emotional fluctuations ortired to stay up late,1（1.75%）patient after a large number of drinking,1（1.75%）patient after fall,1（1.75%）patient after exelcymosis,1（1.75%）patient after neck massage.47（82.46%）patients are acute onset,3（5.26%）patients are subacute onset,2（3.51%）patients are chronic onset,4（7.02%）patients are illness relapses,1（1.75%） patient illness became progressielysicker. The original symptoms were headache, which accounted for84.21%，Afew patients with neck back pain, dizziness onset.47（82.46%）patients withconcomitant symptom of ausea vomiting,24（42.11%）patients with dizzy,11 （19.30%）patients with cervicodorsal pain, A few patients with tinnitus,hearing loss, inspect content double and vision loss and numbness, mentaldisorders and disorder of consciousness, etc.28（49.12%）patients had neckstiffness, a few patients with external ophthalmoplegia and nystagmus.Auxiliary examination find SIH patients sinus bradycardia, most of themCSF opening pressure <70mm H2O.The color of cerebrospinal fluid can showcolorless transparent, light yellow transparent and uniform blood color. CSFtest find white count, protein can moderately elevated, the lymphocyteprimarily. evidence of low CSF pressure on MRI,21patients with subduraleffusion, hemorrhage, ventricle decrescent, cerebellar tonsillar hernia, duralunder thick or pituitary swelling.Through rehydration and symptomatic supporttreatment all of the patients had some degree of improvements.Conclusions：1. Most SIH patients are middle-aged, acute or subacuteonset, females are more common than males,most of whom have risk factors.2.Most of them clinical expression are typical, diffuse and/or dull headache thatworsens after sitting or standing,neck stiffness.3.If clinical expression istypical, especially with thronic course,they need head imaging examination asearly as possible. Try to reduce lumbar puncture.