摘要： 目的 报告1例自发性低颅压综合征伴脑静脉窦血栓形成病例的临床过程，并对其病因以及诊断与治疗进行分析，以提高临床医师相关认知水平。方法与结果 患者男性，34岁，以持续性后枕部胀痛伴间断性搏动样疼痛发病，发作时与体位或昼夜节律无关，症状呈渐进性加重。初诊为脑静脉窦血栓形成，采取脑静脉窦机械取栓+接触性溶栓，疗效欠佳；后经头部MRI及磁共振脊髓成像修正诊断为自发性低颅压综合征伴脑静脉窦血栓形成，经平卧位、补液、激素、抗凝、降纤治疗，头痛症状消失，实验室指标恢复至正常值范围，出院后无复发。结论 对临床无明显直立位头痛的脑静脉窦血栓形成患者，应注意分析影像学和临床资料，以免漏诊自发性低颅压综合征的可能。

关键词: 颅内低压, 窦血栓形成,颅内, 脑静脉, 机械溶栓

Abstract: Objective According to the diagnosis and treatment process of a case of spontaneous intracranial hypotension (SIH) with cerebral venous sinus thrombosis (CVST), the etiology, diagnosis and treatment were analyzed in order to improve the clinicians' understanding. Methods and Results A 34-year-old male patient developed persistent headache in the occipital region accompanied by intermittent throb-like pain. The onset was independent of body position or circadian rhythm, and the symptoms were progressively aggravated. The patient was initially diagnosed with CVST, and gained a poor curative effect of endovascular treatment and anticoagulant therapy. The subsequent diagnosis of SIH with CVST was corrected by head MRI and magnetic resonance myelography (MRM). After bedrest, hydration, steroids, anticoagulation and defibration therapy, the headache symptoms disappeared and the laboratory test results returned to the normal range. There was no recurrence after discharge. Conclusions For CVST patients without typical orthostatic headache, more attentions should be paid to the analysis of imaging findings and clinical data, in order to avoid the possibility of missed diagnosis of intracranial hypotension syndrome (IHS).

Key words: Intracranial hypotension, Sinus thrombosis, intracranial, Cerebral veins, Mechanical thrombolysis