Spontaneous intracranial hypotension: the role of radiology in diagnosis and management

2021 ◽  
Author(s):  
L. Carlton Jones ◽  
D. Butteriss ◽  
D. Scoffings
Keyword(s):  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension ◽  
Diagnosis And Management

Expert Commentary: Role of Surgery for the Management of CSF Leaks

Cephalalgia ◽  
2008 ◽  
Vol 28 (12) ◽  
pp. 1357-1360 ◽  
Author(s):  
B Mokri
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intracranial Hypotension ◽  
Dural Puncture ◽  
Spontaneous Intracranial Hypotension ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Expert Commentary ◽  
Csf Leaks

Spontaneous intracranial hypotension (SIH) was described nearly 70 years ago, and for years it was essentially equated with post dural puncture headaches (PDPH) (1). The interest in this entity substantially increased after the magnetic resonance imaging (MRI) abnormalities of this disorder were recognized in the early 1990s (2-6), and consequently many more patients were diagnosed than before and a far broader clinical spectrum of this disorder began to become apparent. It also came to be recognized that the overwhelming majority if not all cases of SIH result from spontaneous cerebrospinal (CSF) leaks and that the independent pathogenic parameter is loss of CSF volume (7).

scholarly journals Cryptogenic Cerebrospinal Fluid Leaks in Spontaneous Intracranial Hypotension: Role of Dynamic CT Myelography

Radiology ◽  
2018 ◽  
Vol 289 (3) ◽  
pp. 766-772 ◽  
Author(s):  
Tomas Dobrocky ◽  
Pascal J. Mosimann ◽  
Felix Zibold ◽  
Pasquale Mordasini ◽  
Andreas Raabe ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension ◽  
Dynamic Ct ◽  
Ct Myelography ◽  
Cerebrospinal Fluid Leaks

scholarly journals Surgical intervention for spontaneous intracranial hypotension Type 4 CSF leak: A case report

2020 ◽  
Vol 11 ◽  
pp. 421
Author(s):  
Saba Shahab ◽  
Mohamed A. R. Soliman ◽  
Abdullah F. Alkhamees ◽  
Sydney Eaton ◽  
Elise Quint ◽  
...  
Keyword(s):  
Intracranial Hypotension ◽  
Conservative Therapy ◽  
Surgical Intervention ◽  
Spontaneous Intracranial Hypotension ◽  
Rare Condition ◽  
Csf Leak ◽  
Mri Scans ◽  
The Brain ◽  
Csf Leaks

Background: Spontaneous intracranial hypotension (SIH) is a rare condition that can be very debilitating. SIH is well understood to be due to a CSF leak, however, identifying the source of the leak is still a challenge. We are presenting a case of Type 4 CSF leak and reviewing the related literature. Case Description: A 46-year-old female presenting with intractable orthostatic headaches was diagnosed with SIH. She was unable to mobilize due to the severity of her symptoms. MRI scans of the brain and spine did not identify a source of the leak. After failing conservative therapy and multiple epidural blood patches, the patient underwent surgery which resulted in significant improvement in symptoms. Conclusion: This study has shown that surgical intervention improves symptoms in patients who do not have an identifiable source of CSF leak. Further studies need to be done to fully understand the role of surgery in Type 4 CSF leaks.

scholarly journals The algorithm for diagnosis and management of intracranial hypotension with coma: Report of two cases

2020 ◽  
Vol 11 ◽  
pp. 267
Author(s):  
Shintaro Arai ◽  
Keisuke Takai ◽  
Makoto Taniguchi
Keyword(s):  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension ◽  
Csf Leak ◽  
Diagnosis And Management ◽  
Blood Patch ◽  
Dural Leak ◽  
Brain Sagging ◽  
Early Performance ◽  
Dural Tears ◽  
Ct Studies

Background: Spontaneous intracranial hypotension (SIH) is caused by spontaneous cerebrospinal fluid (CSF) leaks that can be treated in most cases with an epidural blood patch (EBP). However, some patients, who develop severe brain sagging, can neurologically deteriorate, and in occasional instances, which become comatose. Here, with the presentation of two cases, and a review of the literature, we have set guidelines for diagnosing SIH along with recommendations for its management. Case Description: We reviewed two cases of SIH. Both patients became comatose due to a CSF leak associated with a tear in the spinal dura diagnosed on myelo-CT studies. As targeted EBP failed to achieve sustained improvement, direct operative repair of the dural tears was warranted (video presentation). Conclusion: After reviewing two cases of SIH and the literature, we developed an algorithm for the diagnosis and management of SIH. To avoid deterioration to a comatose status, we recommend the early performance of myelo- CT studies to identify the location of the dural leak, followed by early dural repair.

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