posttraumatic hypotension syndrome
Introduction
Introduction to low intracranial pressure syndrome after trauma Post-traumatic low intracranial pressure syndrome refers to the syndrome caused by the patient's lateral lumbar puncture pressure below 7.84 kPa. The range of normal intracranial pressure should be between 7.84 and 11.8 kPa (80 to 120 mm H2O) as measured by lumbar puncture. Generally, intracranial pressure after craniocerebral injury often has different degrees of elevation, and there are fewer patients with low intracranial pressure. Some patients have had intracranial pressure in the early stage after injury, and intracranial hypotension occurs after sputum. Its incidence is about 5%. The cause of intracranial hypotension may be caused by cerebral vasospasm after injury, which may inhibit the secretion of cerebrospinal fluid from the choroid plexus, and may also be secondary to cerebrospinal fluid leakage, shock, severe dehydration, hyponatremia, hyperventilation, and surgery or The waist wears out too much cerebrospinal fluid. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: intracranial hemorrhage
Cause
Causes of low intracranial pressure syndrome after trauma
May originate in the cerebral vasospasm after injury, so that the function of the choroid plexus to secrete cerebrospinal fluid is inhibited, may also be secondary to cerebrospinal fluid leakage, shock, severe dehydration, hyponatremia, hyperventilation and excessive cerebrospinal fluid during surgery or lumbar puncture Wait.
Prevention
Prevention of low intracranial pressure syndrome after trauma
The disease is a traumatic disease, pay attention to safety, drive carefully, keep the home environment bright, walk carefully, watch children and avoid trauma.
Complication
Complications of low intracranial pressure syndrome after trauma Complications intracranial hemorrhage
Easy to have intracranial oozing or bleeding, subdural hematoma.
Symptom
Symptoms of low intracranial pressure syndrome after trauma Common symptoms Nausea dizziness, fatigue, dizziness, anorexia, conscious disorder, coma, severe headache, low blood pressure, loss of water
Headache is the main symptom, which occurs more than 1-2 hours or 2-3 days after injury. It is located in the forehead and posterior occipital region. It is exacerbated by the increase of the head position and can be radiated to the whole body. When the supine position or the head position is low, The headache is relieved or disappeared, followed by dizziness and vomiting. Every time there is a change in head position or after a severe headache, dizziness, nausea and vomiting occur. Patients often have fine arterial speed, low blood pressure, photophobia, fatigue, anorexia. Loss of water and neck stiffness, etc., when severe, there may be disturbance of consciousness, light sleepiness, severe coma, a few patients may have autonomic symptoms, such as significant fluctuations in vital signs, facial and neck skin paroxysmal flush, even Individual patients lose the cavitation and cushioning effect of cerebrospinal fluid, and the cranial nerves are directly squeezed or involved, and the pupils are unequal and/or abductor muscle paralysis. The diagnosis of traumatic low intracranial pressure syndrome is mainly It relies on clinical features and lumbar puncture to confirm the diagnosis.
Examine
Examination of low intracranial pressure syndrome after trauma
Mainly relying on clinical features and lumbar puncture pressure to confirm the diagnosis, lumbar puncture lying pressure measurement below 80mmH2O can be clearly diagnosed, if the pressure is lower than 40mmH2O is a severe low intracranial pressure.
Diagnosis
Diagnosis and diagnosis of low intracranial pressure syndrome after trauma
The diagnosis of traumatic low intracranial pressure syndrome relies mainly on clinical features and lumbar puncture pressure to confirm the diagnosis. Clinically, after a head injury, heavier symptoms such as dizziness, headache, fatigue, anorexia, etc., are inconsistent with the severity of brain damage, especially when there is a significant increase in head-head headache and a reduction in head pain. That is, the possibility of intracranial hypotension should be considered. If the lumbar puncture position is below 80mmH2O, the diagnosis can be confirmed. If the pressure is lower than 40mmH2O, it is a severe low intracranial pressure, often accompanied by severe water loss and electrolyte imbalance. Because the intracranial pressure is significantly reduced, the brain volume is reduced, the intracranial vein is dilated and pulled, and it is easy to cause bleeding or bleeding. Therefore, the cerebrospinal fluid is often yellow or has different numbers of red blood cells, and the protein content is slightly higher. Individual patients are even concurrent. Subdural hematoma. Therefore, some authors have suggested that lumbar puncture should not be performed for patients with intracranial hypotension, so as to avoid further aggravation of cerebrospinal fluid loss. It is recommended to use the ventricle drilling method to treat the intracranial hypotension, which is accurate and safe. In fact, in the case of brain imaging for examination has been highly developed today, as long as the clinical features are consistent, if CT or MRI examination has excluded other potentially confusing lesions, it can be confirmed by treatment trials, using supine or high-head low-level inhalation 5% CO2 and 95% 2 mixed gas for 5 to 10 minutes or intravenous distilled water 10 to 15 ml to observe whether the headache is relieved or disappeared.
Through clinical features and lumbar puncture pressure measurement is generally clear, easy to identify with other headaches.
