False localizing sign of C1-2 cerebrospinal fluid leak in spontaneous intracranial hypotension
False localizing sign of C1-2 cerebrospinal fluid leak in spontaneous intracranial hypotension
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DOI：
10.3171/jns.2004.100.4.0639
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发表时间：
2004-04-01
影响因子：
4.1
通讯作者：
Tourje, J
中科院分区：
文献类型：
--
作者：
Schievink, WI;Maya, MM;Tourje, J
Object.由于脊髓脑脊液（CSF）漏引起的自发性颅内低血压是每日新发持续性头痛的重要原因。脊髓神经影像学在这些患者的治疗中很重要，特别是当考虑直接修复CSF泄漏时。脊髓后C1 -2积液可在脊髓成像中发现，通常认为这些积液与脑脊液漏的部位相对应。作者进行了一项研究，以确定这些C1-2液体收集的意义。患者人群包括一组连续的25名患者（18名女性和7名男性），他们接受了自发性脊髓CSF漏的手术修复评价。18例患者的平均年龄为38岁（范围13-72岁）。所有患者均接受计算机断层扫描脊髓造影。3名患者（1 - 2%）有广泛的脊髓后C1-2积液;这名女性和这两名男性的平均年龄为41岁（范围39-43岁）。这些患者脑脊液漏的实际部位位于下颈椎，与脊髓后C1-2积液部位不一致。在自发性低颅压患者中，C1-2节段的脊髓后液收集不一定指示CSF渗漏的部位。这是治疗这些患者时的重要考虑因素，因为治疗可能无意中针对该部位。
Object. Spontaneous intracranial hypotension due to a spinal cerebrospinal fluid (CSF) leak is an important cause of new daily persistent headaches. Spinal neuroimaging is important in the treatment of these patients, particularly when direct repair of the CSF leak is contemplated. Retrospinal C 1-2 fluid collections may be noted on spinal imaging and these are generally believed to correspond to the site of the CSF leak. The authors undertook a study to determine the significance of these C1-2 fluid collections.Methods. The patient population consisted of a consecutive group of 25 patients (18 female and seven male) who were evaluated for surgical repair of a spontaneous spinal CSF leak. The mean age of the 18 patients was 38 years (range 13-72 years). All patients underwent computerized tomography myelography. Three patients (12%) had extensive retrospinal C1-2 fluid collections; the mean age of this woman and these two men was 41 years (range 39-43 years). The actual site of the CSF leak was located at the lower cervical spine in these patients and did not correspond to the site of the retrospinal C1-2 fluid collection.Conclusions. A retrospinal fluid collection at the C1-2 level does not necessarily indicate the site of the CSF leak in patients with spontaneous intracranial hypotension. This is an important consideration in the treatment of these patients because therapy may be inadvertently directed at this site.