Hypotension syndrome for more than 20 days?

summary

Intracranial hypotension syndrome is a clinical syndrome characterized by positional headache, which is caused by various reasons. The cerebrospinal fluid pressure in lumbar subarachnoid space is below 0.59 kPa (60mmh2o) in lateral position. Hypotension syndrome for more than 20 days? Let's talk about it

Hypotension syndrome for more than 20 days?

The onset of intracranial hypotension can be very sudden, more common in young adults, male than female, its clinical characteristics are severe headache, headache or occipitocervical frontotemporal persistent swelling pain or no fixed position pain, can radiate to the neck and shoulder. Headache worsens when sitting up, standing up and moving. Headache alleviates or disappears when lying on the back or when head is low and feet are high.

It is often accompanied by nausea, vomiting, tinnitus, photophobia, vertigo, gait instability, and a few have transient syncope, mental disorder, convulsions, palpitations, sweating. The aggravation of headache when standing may be related to the decrease of CSF pressure itself and the displacement of pain sensitive structures on the cerebral fornix when standing.

The elderly patients presented with vertigo, accompanied by heavy head or dizziness. Occasionally, headache and vertigo may be related to the limited blood supply insufficiency of basilar artery, which can be caused by the decrease of cerebrospinal fluid production caused by choroid plexus vasospasm. Physical examination showed bradycardia, rigidity of neck, tenderness of neck muscle, positive for Klinefelter's disease, bilateral or unilateral abducens nerve insufficiency paralysis, blurred fundus optic papilla, and no positive signs of nervous system.

matters needing attention

(1) It is better to use intracranial pressure monitor to guide the application time and dosage. Once it is improved, it should be reduced and stopped in time（ 2) The indications of lumbar puncture should be strictly controlled（ 3) For patients with multiple traumatic shock, hypotension shock should be corrected in time, and perfusion pressure and cerebral blood flow should be restored in time.