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Journal of Zhejiang University SCIENCE B
ISSN 1673-1581(Print), 1862-1783(Online), Monthly
2017 Vol.18 No.7 P.577-585
Factors affecting cerebrospinal fluid opening pressure in patients with spontaneous intracranial hypotension
Abstract: Objective: Spontaneous intracranial hypotension (SIH) is recognized far more commonly than ever before. Though usually characterized by low cerebrospinal fluid (CSF) pressure, some patients with SIH are observed to have normal pressure values. In this study, we aimed to confirm the proportion of patients with normal CSF opening pressure (CSF OP) and explore the factors affecting CSF OP in SIH patients. Methods: We retrospectively reviewed 206 consecutive SIH patients and analyzed their clinical and imaging variables (including demographic data, body mass index (BMI), duration of symptoms, and brain imaging findings). Univariate and multivariate analyses were performed to identify the potential factors affecting CSF OP. Results: In a total of 114 (55.3%) cases the CSF OP was ≤60 mmH2O (1 mmH2O=9.806 65 Pa), in 90 (43.7%) cases it was between 60 and 200 mmH2O, and in 2 (1.0%) cases it was >200 mmH2O. Univariate analysis showed that the duration of symptoms (P<0.001), BMI (P<0.001), and age (P=0.024) were positively correlated with CSF OP. However, multivariate analysis suggested that only the duration of symptoms (P<0.001) and BMI (P<0.001) were strongly correlated with CSF OP. A relatively high R2 of 0.681 was obtained for the multivariate model. Conclusions: Our study indicated that in patients without a low CSF OP, a diagnosis of SIH should not be excluded. BMI and the duration of symptoms can influence CSF OP in SIH patients, and other potential factors need further investigation.
Key words: Spontaneous intracranial hypotension; Low cerebrospinal fluid opening pressure; Body mass index; Magnetic resonance imaging
创新点:通过大样本容量的病例证实了正常脑脊液开放压在SIH患者中占较高比例,并进一步得出体重指数和症状持续时间与脑脊液开放压存在显著相关性。
方法:回顾了206例在我院确诊的SIH患者,收集其人口学信息、体重指数、症状持续时间、影像检查结果等资料。通过单变量分析和多变量分析识别影响脑脊液开放压的潜在因素。
结论:本研究进一步证实正常脑脊液开放压在SIH患者中并不少见,特别是那些肥胖和症状持续时间长的患者。除了体重指数和症状持续时间,仍然存在其他未识别的因素影响SIH患者的脑脊液开放压大小。
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DOI:
10.1631/jzus.B1600343
CLC number:
R741
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On-line Access:
2017-07-05
Received:
2016-08-01
Revision Accepted:
2016-10-26
Crosschecked:
2017-06-16