Lumbar puncture-related cerebrospinal fluid leakage on magnetic resonance myelography: is it a clinically significant finding?
Lumbar puncture-related cerebrospinal fluid leakage on magnetic resonance myelography: is it a clinically significant finding?
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DOI：
10.1186/1471-2253-13-35
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发表时间：
2013-10-27
影响因子：
2.2
通讯作者：
Shibamoto, Yuta
中科院分区：
文献类型：
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作者：
Sakurai, Keita;Matsukawa, Noriyuki;Shibamoto, Yuta
背景：硬膜穿刺后头痛（PDPH）由于脑脊液（CSF）漏过多是腰椎穿刺术的常见并发症。尽管已证明各种因素（尤其是脊椎针类型）与PDPH相关，但磁共振脊髓造影（MRM）图像上检测到的CSF泄漏的临床意义仍不清楚。本病例对照研究的目的是评估影像学显示的脑脊液漏与PDPH之间的关系。方法：比较影像学显示脑脊液漏阳性和阴性患者的临床资料，包括患者的年龄和性别、脊椎穿刺针类型、卧床时间、腰椎穿刺程序和MRM研究之间的间隔以及PDPH的发生率。在MRM图像上有明确脑脊液漏的22例患者中，大多数无症状（86%，19/22）。其余三名患有PDPH的患者仅主诉头痛，并接受了保守治疗。在审查患者的临床资料，有没有显着差异，包括PDPH的发病率之间的22例患者谁是放射学阳性的CSF泄漏和31放射学阴性patients.Conclusion：的意义，放射学可视化CSF泄漏不应高估，因为大多数这样的事件是不相关的PDPH，不需要任何治疗。
Background: Post-dural puncture headache (PDPH) due to excessive cerebrospinal fluid (CSF) leakage is a well-known complication of lumbar puncture. Although various factors, especially the type of spinal needle, have been demonstrated to be associated with PDPH, the clinical implications of CSF leakage detected on magnetic resonance myelography (MRM) images remain unclear. The objective of this case-control study was to evaluate the association between radiologically visualized CSF leakage and PDPH.Methods: Clinical data including patients' age and gender, types of spinal needle, duration of bed rest, interval between lumbar puncture procedures and MRM studies, and incidence of PDPH were compared between patients who were radiologically-positive and -negative for CSF leakage.Results: Of the 22 patients with definite CSF leakage on MRM images, most were asymptomatic (86%, 19/22). The remaining three patients, who were suffering from PDPH, only complained of headaches and were treated conservatively. In a review of patients' clinical data, there were no significant differences in any parameter including the incidence of PDPH between the 22 patients who were radiologically-positive for CSF leakage and the 31 radiologically-negative patients.Conclusion: The significance of radiologically visualized CSF leakage should not be overestimated, as most such incidents are not associated with PDPH and do not require any treatment.