Electroencephalogram Abnormalities During Positional Changes in Brain Sagging Syndrome

2018 ◽  
Vol 35 (4) ◽  
pp. 351-354
Author(s):  
Benziger Bensam ◽  
Heustein L. Sy ◽  
Nadia Sotudeh ◽  
Paulomi K. Bhalla ◽  
Sean T. Hwang ◽  
...  
Keyword(s):  
Brain Sagging

Spontaneous Spinal Cerebrospinal Fluid Leaks

Cephalalgia ◽  
2008 ◽  
Vol 28 (12) ◽  
pp. 1345-1356 ◽  
Author(s):  
WI Schievink
Keyword(s):  
Cerebrospinal Fluid ◽  
Spontaneous Intracranial Hypotension ◽  
Csf Leak ◽  
Epidural Blood Patching ◽  
Delay In Diagnosis ◽  
Facial Numbness ◽  
Cerebrospinal Fluid Leaks ◽  
Brain Sagging ◽  
Glue Injection ◽  
Fluid Collections

Spontaneous intracranial hypotension is an uncommon but not rare cause of new onset daily persistent headaches. A delay in diagnosis is the norm. Women are affected more commonly than men and most are in the fifth or sixth decade of life. The underlying cause is a spontaneous spinal cerebrospinal fluid (CSF) leak. Typically the headache is orthostatic in nature but other headache patterns occur as well. Associated symptoms are common and include neck pain, a change in hearing, diplopia, facial numbness, cognitive abnormalities and even coma. Typical imaging findings consist of subdural fluid collections, pachymeningeal enhancement, pituitary hyperaemia and brain sagging, but magnetic resonance imaging may be normal. Myelography is the study of choice to identify the CSF leak but is not always necessary to make the diagnosis. Treatment consists of bedrest, abdominal binder, epidural blood patching, percutaneous fibrin glue injection or surgical CSF leak repair. Outcomes have been poorly studied.

Frontotemporal Brain Sagging Syndrome (FBSS) Due to Minor Head Trauma (P03.212)

Neurology ◽  
2012 ◽  
Vol 78 (Meeting Abstracts 1) ◽  
pp. P03.212-P03.212
Author(s):  
K. Robeson ◽  
N. Blondin ◽  
A. Szekely
Keyword(s):  
Head Trauma ◽  
Minor Head Trauma ◽  
Brain Sagging

scholarly journals Frontotemporal brain sagging syndrome: An SIH-like presentation mimicking FTD

Neurology ◽  
2011 ◽  
Vol 76 (16) ◽  
pp. 1377-1382 ◽  
Author(s):  
M. R. Wicklund ◽  
B. Mokri ◽  
D. A. Drubach ◽  
B. F. Boeve ◽  
J. E. Parisi ◽  
...  
Keyword(s):  
Brain Sagging

scholarly journals Lessons of the month 3: Spontaneous resolution of frontotemporal brain sagging syndrome

2019 ◽  
Vol 19 (4) ◽  
pp. 336-337 ◽  
Author(s):  
Louisa Kent ◽  
Richard Butterworth ◽  
Chris Butler
Keyword(s):  
Spontaneous Resolution ◽  
Brain Sagging

Behavioral Variant Frontotemporal Dementia as a Serious Complication of Spontaneous Intracranial Hypotension

2018 ◽  
Vol 15 (5) ◽  
pp. 505-515 ◽  
Author(s):  
Wouter I Schievink ◽  
M Marcel Maya ◽  
Zachary R Barnard ◽  
Franklin G Moser ◽  
Stacey Jean-Pierre ◽  
...  
Keyword(s):  
Frontotemporal Dementia ◽  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension ◽  
Csf Leak ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Clinical Criteria ◽  
Epidural Blood Patching ◽  
Early Onset Dementia ◽  
Percutaneous Procedures ◽  
Brain Sagging

Abstract BACKGROUND Behavioral variant frontotemporal dementia (bvFTD) is a devastating early onset dementia. Symptoms of bvFTD may be caused by spontaneous intracranial hypotension (SIH), a treatable disorder, but no comprehensive study of such patients has been reported. OBJECTIVE To describe detailed characteristics of a large cohort of patients with SIH and symptoms of bvFTD. METHODS We identified patients with SIH who met clinical criteria for bvFTD. Patients were compared to a cohort of SIH patients without bvFTD. RESULTS The mean age for the 21 men and 8 women was 52.9 yr (range, 37–65 yr). All 29 patients with bvFTD symptoms had hypersomnolence. Magnetic resonance imaging showed brain sagging in all patients, cerebrospinal fluid (CSF) opening pressure low in about half of patients, but a spinal CSF leak could not be detected in any patient. All patients underwent epidural blood patching, but 26 patients eventually underwent 1 or more surgical procedures. Overall, a good outcome was obtained in 21 patients (72%); 20 (91%) of 22 patients who had not undergone prior Chiari surgery compared to 1 (14%) of 7 patients who did undergo Chiari surgery (P < .003). Compared to SIH patients without symptoms of bvFTD (n = 547), those with bvFTD symptoms were older, more often male, less often demonstrated CSF leak on spinal imaging, and more often underwent surgery (P < .02). CONCLUSION bvFTD in SIH is rare and associated with brain sagging and hypersomnolence. Spinal CSF leaks are rarely detected. bvFTD symptoms are often refractory to the usual percutaneous procedures but most patients can be cured.

Reversible amnestic cognitive impairment in a patient with brain sagging syndrome

2020 ◽  
pp. 10.1212/CPJ.0000000000000860
Author(s):  
Ana Vives-Rodriguez ◽  
Katherine W. Turk ◽  
Elizabeth A. Vassey ◽  
Tarun Singhal ◽  
Charles H. Cho ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Brain Sagging

We describe an amnestic pattern of cognitive impairment in a patient with brain sagging syndrome (BSS) due to a dural diverticulum and its reversibility after treatment.

scholarly journals Frontotemporal brain sagging syndrome: Craniospinal hypovolemia secondary to a T6-T7 cerebrospinal fluid-venous fistula

2020 ◽  
Vol 11 ◽  
pp. 250
Author(s):  
Luis Alberto Ortega-Porcayo ◽  
Eduardo Perusquia Ortega ◽  
Oscar Quiroz-Castro ◽  
Roger Antonio Carrillo-Meza ◽  
Juan Antonio Ponce-Gomez ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Csf Leak ◽  
Mri Findings ◽  
Surgical Clipping ◽  
Progressive Decline ◽  
Magnetic Resonance Imaging Mri ◽  
Brain Sagging ◽  
Venous Fistula ◽  
Ct Studies

Background: The frontotemporal brain sagging syndrome (FTBSS) is defined as an insidious/progressive decline in behavior and executive functions, hypersomnolence, and orthostatic headaches attributed to cerebrospinal fluid (CSF) hypovolemia. Here, a T6 CSF-venous fistula (e.g., between the subarachnoid CSF and a paraspinal vein) resulted in a CSF leak responsible for craniospinal hypovolemia. Case Description: A 56-year-old male started with orthostatic headaches and fatigue after scuba diving. His symptoms included progressive, vertigo, tinnitus, nausea, lack of judgment, inappropriate behavior, memory dysfunction, apathy, tremor, orofacial dyskinesia, dysarthria, dysphagia, and hypersomnolence. The lumbar puncture revealed an opening pressure of 0 cm H2O. Magnetic resonance imaging (MRI) findings included brain sagging, bilateral temporal lobe herniation, and pachymeningeal enhancement. The computed tomography (CT) myelogram showed a thoracic diverticulum and a CSF-venous leak at the T6-T7 level. Surgery, which comprised a T6-T7 laminotomy, allowed for dissecting, clipping, and ligating the diverticulum/fistula. The patient improved postoperatively (e.g., cognitive, behavioral, and brainstem symptoms). The follow-up MRI’s showed the reversion of the sagging index/uncal herniation. Conclusion: The FTBSS should be considered in the differential diagnosis of an early onset frontotemporal dementia. Establishing the diagnosis and localizing the site of a spinal CSF/venous leak warrant both MRI and myelogram CT studies, to pinpoint the CSF leak site for proper surgical clipping/ligation of these thoracic diverticulum/CSF-venous leaks.

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