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J Korean Neurol Assoc. 2014;32(1):14-18.
- Relationship Between Findings on Brain MRI and Prognosis in
Patients With Spontaneous Intracranial Hypotension
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Myung-Ho Park
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Department of Neurology and Radiology
, Chonnam National University Medical School, Gwangju, Korea
- 자발두개내압저하 환자에서 뇌자기공명영상 결과와
예후의 상관관계
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박명호, 김병채 최성민 김동은 최강호 김준태 윤 웅
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남태승 이승한 박만석 김명규 조기현
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전남대학교 의과대학 신경과학교실, 영상의학과학교실
a
- Abstract
- Background
The outcome of spontaneous intracranial hypotension (SIH) is unpredictable and some patients have
persistent and often incapacitating symptoms. This study was aimed to investigate whether abnormalities on initial
magnetic resonance imaging (MRI) can predict the outcome in patients with SIH.
Methods
We retrospectively included 44 patients with SIH. Brain MRI was available for all patients. Treatment
consisted of conservative treatment and/or high-volume epidural blood patching. Patients were divided into two
groups: favorable or non-favorable group. Favorable group was defined as clinical improvement by conservative
therapy or one trial of autologous epidural blood patching; non-favorable group as more than two week of admission,
two or more trials of autologous epidural blood patching, or relapse of orthostatic headache.
Results
Twenty-one (48%) of 44 patients were classified as the favorable group. The non-favorable group had several
abnormal findings on brain MRI (16 cases vs. 5 cases in favorable group, p<0.003), including platybasia (1), skull base
tumor (1), Chiari I malformation (1), diffuse mild thickening and enhancement of dural and epidural layer of thoracic
spine (1), pituitary enlargement (3), sagging brain (3) and subdural hemorrhage (4). In the non-favorable group, 13 out of
23 patients (57%) showed pachymeningeal enhancement in brain MRI (2 patients in favorable group, p<0.001).
Conclusions
Brain MRI abnormalities were more frequently related with non-favorable outcomes in SIH. Pachymeningeal
enhancement in particular could suggest an unfortunate prognosis. Key Words: Spontaneous intracranial hypotension, Pachymeningeal enhancement, Epidural blood patch
Keywords :
- 초록
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