Intracranial hypotension headache

Introduction to intracranial hypotension headache Intracranial hypotension headache refers to cerebrospinal fluid fistula or lumbar puncture after trauma, so that the cerebrospinal fluid continues to exude too much from the puncture site to the outside of the meninges, resulting in decreased pressure in the spinal canal, and the pain sensitive tissue of the posterior fossa is pulled. The headache caused by the lower back, the common headache after lumbar puncture. basic knowledge The proportion of illness: 0.03% Susceptible people: no special people Mode of infection: non-infectious Complications: dizziness, disturbance of consciousness

Intracranial hypotensive headache

Cause:

Except for cerebrospinal fluid fistula that occurs after injury, common diseases are due to headache after lumbar puncture, excessive fluid discharge during lumbar puncture, or postoperative cerebrospinal fluid exudation from the puncture site to the meninges, causing the pressure in the spinal canal to drop. The posterior fossa pain sensitive tissue is pulled down and causes headache.

Intracranial hypotension headache prevention

When the waist is worn, a fine needle should be used. It is helpful to prevent headache after lying for 6 hours.

Inpatient care: When the intracranial pressure is low through rest and sedative application, the hospital is given a hypotonic solution to stimulate the secretion of cerebrospinal fluid to eliminate pain. Commonly used drugs are intravenously injected into sterile distilled water. Pay attention to the following when injecting:

(1) Pay attention to aseptic operation.

(2) Note that the dose and bolus rate should not be too fast to prevent intravascular hemolysis.

(3) pay attention to observe the patient's performance, whether there is cold, limb numbness, back pain, purpura and other early manifestations of hemolysis, once found, immediately stop using the drug and cooperate with the doctor for rescue.

Life care: patients should drink more water, pay attention to work and rest, reduce standing for a long time, if necessary, take the head low to high to relieve headache symptoms.

Intracranial hypotensive headache complications Complications, dizziness, disturbance

It usually recovers naturally within 1 to 3 days, without complications, may be accompanied by dizziness and vomiting, and severe cases may have conscious disturbances.

Intracranial hypotensive headache symptoms Common symptoms Dizziness forehead pain Dizziness nausea and vomiting Nausea neuralgia Sensory disorder Dizziness Unilateral headache Child headache

Usually there is dull or pulsating pain in the occipital or forehead within a few hours after surgery. The headache is aggravated when sitting or standing. After supine, it usually recovers within 1 to 3 days. A few cases can last longer. Time, there may be dizziness and vomiting, and severe cases may have conscious disturbances.

Examination of intracranial hypotension headache

1. Mainly do head CT, exclude space-occupying lesions.

2. Lumbar puncture pressure measurement: According to the typical clinical features of orthostatic headache, low cranial pressure headache should be suspected. Lumbar puncture measurement can reduce the cerebrospinal fluid pressure and reduce the intracranial pressure syndrome (<70mmH2O). In some cases, the pressure could not be measured, and the CSF could not be released, which was a "dry puncture". In a few cases, the number of CSF cells increased slightly, and the levels of protein, sugar, and green chloride were normal. The disease should be differentiated from certain diseases that produce orthostatic headaches, such as brain and spinal cord tumors, ventricular obstruction syndrome, parasitic infections, cerebral venous thrombosis, subacute subdural hematoma and cervical spondylosis.

Diagnosis and diagnosis of intracranial hypotension headache

The disease is differentiated from other types of headaches, and there is no history of lumbar puncture. The intracranial pressure can be identified.

1, migraine

It is a vascular headache and is common in young and middle-aged children. The headache is located on one side of the forehead, with pulsating and jumping pain, often accompanied by nausea and vomiting. For a paroxysmal headache, there may be visual disturbances such as blurred vision, blind spots or hemianopia in the visual field before the headache, or a partial headache without any warning. It usually lasts for hours or days, and very few patients have a migraine persistence. A small number of patients with migraine may coexist with a tension headache, making it difficult to distinguish between the two.

2, cluster headache

This type of headache may be vascular and associated with hypothalamic dysfunction. The headache is located on one side of the forehead, and the heavy one spreads over the entire head. Headache episodes are dense, intense and without aura. The headache is rapid and can stop suddenly. The attack was accompanied by conjunctival congestion, tearing, runny and sweating, and a few cases of ptosis. It occurs several times a day and can occur during sleep. Each episode lasts for several tens of minutes to several hours and can last for several days to several weeks, but the remission period can last from several months to several years. After detailed examination of the patient's medical history and seizure, it is not difficult to identify with the tension headache.

3, trigeminal neuralgia

It is a paroxysmal transient pain in the facial trigeminal nerve distribution area. Each pain is only a few seconds, and it occurs several times a day to dozens of times. Pain, such as knife cutting, burning or acupuncture, is often induced by washing your face, brushing your teeth, talking, and chewing. Patients often point to a location that induces pain, called a "trigger point." The disease occurs in the middle and old age, and the second and third branches of the trigeminal nerve are more involved. If the first branch is affected, it should be noted that it should be distinguished from ETTH.

4, headache caused by intracranial space-occupying disease

Such diseases include intracranial tumors, intracranial metastases, brain abscesses, and cerebral parasitic diseases. This type of headache is caused by increased intracranial pressure. It is often accompanied by jet vomiting and fundus edema as the disease progresses, but it can be misdiagnosed as a tension headache in the early stage. For patients with short-term headaches, in addition to paying attention to fundus changes, careful neurological examination is extremely important. If signs such as pathological reflexes are found, it is often indicated that it is not a tension-type headache, and brain CT or MRI should be used in time to help identify.

5, headache caused by chronic intracranial infection

Such diseases include tuberculous meningitis, fungal meningitis, cysticercosis (cysticercosis) meningitis and syphilitic meningitis. These meningitis all have headache as early symptoms, usually accompanied by fever, but some atypical patients, only low fever in the initial stage, and meningeal irritation is negative, it is easy to be misdiagnosed as tension headache. Therefore, when asking about medical history, as long as there has been a history of "cold" or a suspicious pathological reflex in the past, the lumbar puncture should be considered in time to examine the pressure, cytology, biochemistry, tryptophan and ink staining of cerebrospinal fluid. assay. When necessary, blood and cerebrospinal fluid anti-tuberculosis antibodies, cysticercosis (cysticercosis) immunoassay and syphilis test should be tested to help confirm the diagnosis.

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