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目的 对良性颅内压增高的病因进行分析 ,以提高对该病的认识。方法 回顾性总结 2 5例临床诊断为良性颅内压增高患者的临床资料 ,结合文献对其可能的病因、临床症状、体征、实验室及影像学检查以及治疗转归情况进行分析。结果 病因 :静脉窦血栓形成 15例 ,原因不明 6例 ,单纯肥胖、撤激素反应、鼻窦炎、垂体饱满各 1例。临床症状、体征以头痛、恶心、呕吐、视乳头水肿、视物模糊为主。头颅MRI发现空泡蝶鞍 16例。CSF检查 4例蛋白轻度增高 ,2例寡克隆抗体区带 (+)。所有病例均行降颅压治疗 ,抗凝治疗 7例 ,加用激素治疗 3例 ,加用开颅减压治疗 1例 ,均有不同程度好转。结论 良性颅内压增高并非完全良性 ,有时可导致严重的视力损害。多数均有病因可寻 ,其中由静脉窦血栓形成引起者比例较高 ,部分实验室及影像学检查可有异常发现。因此 ,对良性颅内压增高病人提倡行头颅DSA或MRV以及血凝机制的检查 ,对寻找病因有帮助。早期治疗临床效果佳。
Objective To analyze the etiopathogenisis of benign intracranial hypertension and to raise awareness of the disease. Methods The clinical data of 25 clinically diagnosed patients with benign intracranial hypertension were retrospectively reviewed. The possible etiologies, clinical symptoms, signs, laboratory and imaging findings and treatment outcomes were analyzed. Results etiology: sinus thrombosis in 15 cases, 6 cases of unknown cause, simple obesity, withdrawal hormone reaction, sinusitis, pituitary full in 1 case. Clinical symptoms and signs to headache, nausea, vomiting, papilledema, blurred vision based. 16 cases of craniofacial sella were found in cranial MRI. 4 cases of CSF protein increased mildly, 2 cases of oligoclonal antibody band (+). All patients underwent intracranial pressure treatment, anticoagulant therapy in 7 cases, plus hormone therapy in 3 cases, plus craniotomy decompression in 1 case, all with varying degrees of improvement. Conclusion Increased benign intracranial pressure is not completely benign, sometimes leading to severe visual impairment. Most of the causes can be found, of which caused by the higher proportion of sinus thrombosis, some laboratory and imaging findings may be abnormal findings. Therefore, patients with benign intracranial hypertension advocate cranial DSA or MRV and hemagglutination mechanism of inspection, looking for the cause of help. Early treatment of clinical effect is good.