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单侧静脉窦支架置入治疗特发性颅内压增高症
目的 了解静脉窦狭窄在特发性颅内压增高症中所起的作用以及腔内支架治疗的可行性.方法 回顾性研究应用静脉窦内支架成形术治疗静脉窦狭窄的特发性颅内压增高症的患者,观察资料包括临床症状、眼底检查、颅内压测定、脑血管造影情况、治疗方法、疗效及安全性.结果 研究期间共有7例特发性颅内压增高症患者行逆行脑静脉造影并行静脉窦测压后行静脉窦支架置入术,其中4例伴有头痛,1例伴有鼻漏,术后伴发症状均有改善;7例患者均有视力下降,术后6例视力有所好转,1例术后视力无好转.结论 怀疑存在静脉窦狭窄的特发性颅内压增高患者应行逆行脑静脉造影并且静脉窦测压.对于因静脉窦狭窄引起症状的患者,静脉窦内支架置入是一种可供选择的治疗方案.
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腰池-腹腔分流术治疗特发性颅内压增高症(附43例报告)
目的 分析43例腰池-腹腔分流术治疗特发性颅内压增高症患者的临床资料及手术效果,探讨腰池-腹腔分流术治疗特发性颅内压增高症的临床进展.方法 术前常规检查视力、视野、眼底像并行腰穿测压和相关内分泌及影像学检查,根据术前视力情况进行分组同时对比术后随访资料,评价腰池-腹腔分流术治疗特发性颅内压增高症的临床意义.结果 术前视力在0.1≤视力<0.5的患者术后视力恢复率达86.3%,与其他组别对比差异有统计学意义.结论 腰池-腹腔分流术治疗特发性颅内压增高症有明显疗效,尤其是对于0.1≤视力<0.5的患者应积极手术治疗.
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难治性慢性偏头痛伴颅内静脉窦狭窄患者颅内压监测分析
目的：探讨难治性慢性偏头痛合并颅内静脉窦狭窄时的颅内压状况及腰穿放液治疗的可行性。方法2010-07—2014-10收治的符合难治性偏头痛且合并颅内静脉窦狭窄患者18例，行腰穿放液，评估腰穿后观察指标。结果每月头痛持续的时间减少与基线相比，差异均有统计学意义（P＜0.0001），但第4月与第2、3月相比无显著差异（P＞0.05）。难忍的头痛每月持续时间与基线相比，差异均有统计学意义（P＜0.0001），且第4月与第2、3月相比均有显著差异（P＜0.01）。多因素回归分析未发现显著相关的术前变量。结论多数诊断为难治性慢性偏头痛的患者合并颅内压增高症，腰穿适当放脑脊液可获得较长时间的症状缓解。表现为每日头痛同时伴静脉窦狭窄，且对药物反应不佳的患者，应高度怀疑是否为不伴视乳头水肿的特发性颅内压增高症。
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血管性搏动性耳鸣研究进展
Pulsatile tinnitus (PT) is relatively rare,which accounts for approximately 4％ of patients with tinnitus.It originates from mostly vascular structures within the cranial cavity,head and neck region or thoracic cavity,and is transmitted to the cochlear by bony or vascular structures and the blood flow,stimulating patient's hearing.It can be the patient's subjective feelings,there can be objective performance.Vascular PT is more common than non-vascular PT.Vascular PT can be further classified by vessel of origin as arterial and venous ones,and the latter is more commonly seen clinically.It's rhythm is synchronous with patients' pulse,and its tinnitus frequency is less than 600 Hz.The cause of pulsatile tinnitus is complex and diverse,and 56 cases are reported in the literature.Objective tinnitus or somatosensory,associated with tympanic membrane myoclonus,ear blood flow changes adjacent to blood vessels and other in vivo factors.While subjective tinnitus lacks a clear source of the body.PT's pathogenesis has not been fully understood yet,so intensive study targeting PT is of great importance.This review focuses on the pathophysiological mechanisms,etiology,clinical manifestation,diagnosis and progress of treatment of vascular PT.
