摘要
目的 报告1例恶性颅内高压病例,回顾其诊断与治疗经过,并分析病因,以提高临床医师对恶性颅内高压的认知。方法与结果 男性患者,19岁,亚急性发病,呈慢性病程,以黑蒙、头痛、颈肩痛、视物模糊及耳鸣发病,影像学检查提示脑静脉窦狭窄且狭窄两端存在明显压力差,但脑静脉窦支架植入术无效,经视神经鞘减压术后头痛及视物模糊等症状无明显改善,最终经脑组织活检术确诊为胶质母细胞瘤(WHOⅣ级),手术切除肿瘤灶,术后8个月死亡。结论 恶性颅内高压伴脑静脉窦狭窄两端存在压力差的患者不宜行支架植入术,明确狭窄原因及类型对正确诊断及指导治疗至关重要。
ObjectiveThis paper reports a case of malignant intracranial hypertension,reviews his diagnosisand treatment,andanalyzes his etiology,in order to improve the clinicians’cognition of this disease.Methods and ResultsThe patient was a 19-year-old male with subacute onset and chronic course of disease,presenting with amaurosis,headache,neck and shoulder pain,blurred vision and tinnitus disease.Imaging findings showed cerebral venous sinus stenosis (VSS) with obvious pressure difference at both ends of stenosis.However,venous sinus stenting was ineffective.After optic nerve sheath decompression,the symptoms of headache and blurred vision were not significantly improved.Finally,the patientwasdiagnosed as glioblastoma (WHOⅣ),and died 8 months after removal of the tumor foci.ConclusionsPatients with the pressure difference at both ends of malignant intracranial hypertension with VSS should not take stenting.Clarifying the cause and type of stenosis is very important for correct diagnosis and guide treatment.
作者
曲典
郝文思
连芳
胡舒缘
谷亚钦
段建钢
QU Dian;HAO Wen-si;LIAN Fang;HU Shu-yuan;GU Ya-qin;DUAN Jian-gang(Department of Emergency,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Pathology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《中国现代神经疾病杂志》
CAS
北大核心
2022年第6期500-506,共7页
Chinese Journal of Contemporary Neurology and Neurosurgery
基金
北京市自然科学基金资助项目(项目编号:7182064)。
关键词
胶质母细胞瘤
颅内高压
支架
脑静脉
Glioblastoma
Intracranial hypertension
Stents
Cerebral veins
