scholarly journals Cerebral Venous Thrombosis in Two Patients with Spontaneous Intracranial Hypotension

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
M. C. Garcia-Carreira ◽  
D. Cánovas Vergé ◽  
J. Branera ◽  
M. Zauner ◽  
J. Estela Herrero ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Intracranial Hypotension ◽  
Superior Sagittal Sinus ◽  
Spontaneous Intracranial Hypotension ◽  
Cerebrospinal Fluid Leak ◽  
Cerebral Veins ◽  
Cortical Vein ◽  
Sagittal Sinus ◽  
Fluid Leak

Although few patients with spontaneous intracranial hypotension develop cerebral venous thrombosis, the association between these two entities seems too common to be simply a coincidental finding. We describe two cases of spontaneous intracranial hypotension associated with cerebral venous thrombosis. In one case, extensive cerebral venous thrombosis involved the superior sagittal sinus and multiple cortical cerebral veins. In the other case, only a right frontoparietal cortical vein was involved. Several mechanisms could contribute to the development of cerebral venous thrombosis in spontaneous intracranial hypotension. When spontaneous intracranial hypotension and cerebral venous thrombosis occur together, it raises difficult practical questions about the treatment of these two conditions. In most reported cases, spontaneous intracranial hypotension was treated conservatively and cerebral venous thrombosis was treated with anticoagulation. However, we advocate aggressive treatment of the underlying cerebrospinal fluid leak.

Cerebral venous thrombosis caused by spontaneous intracranial hypotension: two cases

2007 ◽  
Vol 14 (11) ◽  
pp. 1296-1298 ◽  
Author(s):  
S. Richard ◽  
S. Kremer ◽  
J.-C. Lacour ◽  
H. Vespignani ◽  
P. Boyer ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension

Ossified ligamentum flavum of the thoracic spine presenting as spontaneous intracranial hypotension: case report

2018 ◽  
Vol 28 (4) ◽  
pp. 401-405 ◽  
Author(s):  
Mazda K. Turel ◽  
Mena G. Kerolus ◽  
John E. O’Toole
Keyword(s):  
Back Pain ◽  
Thoracic Spine ◽  
Intracranial Hypotension ◽  
Ligamentum Flavum ◽  
Radiological Finding ◽  
Spontaneous Intracranial Hypotension ◽  
Cerebrospinal Fluid Leak ◽  
Accurate Diagnosis ◽  
History Of ◽  
Fluid Leak

Ossification of the ligament flavum in the thoracic spine is an uncommon radiological finding in the Western population but can present with back pain, varying degrees of myelopathy, and even paraplegia on occasion. The authors here present the case of a 50-year-old woman with a history of progressive back pain and symptoms of spontaneous intracranial hypotension who was found to have an ossified ligamentum flavum of the thoracic spine resulting in a dural erosion cerebrospinal fluid leak. Surgery involved removal of the ossified ligament flavum at T10–11, facetectomy, ligation of the nerve root, and primary closure of the dura, which resulted in complete resolution of the patient’s symptoms. Radiological, clinical, and intraoperative findings are discussed to assist surgeons with an accurate diagnosis and treatment in the setting of this unusual presentation.

scholarly journals Spontaneous intracranial hypotension complicated by cerebral venous thrombosis

2018 ◽  
Vol 13 (4) ◽  
pp. 834-838 ◽  
Author(s):  
Nana Fujii ◽  
Hiroyuki Fujii ◽  
Akifumi Fujita ◽  
Younhee Kim ◽  
Hideharu Sugimoto
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension

Spontaneous Intracranial Hypotension with Isolated Cortical Vein Thrombosis and Subarachnoid Haemorrhage

Cephalalgia ◽  
2007 ◽  
Vol 27 (12) ◽  
pp. 1413-1417 ◽  
Author(s):  
Y-F Wang ◽  
J-L Fuh ◽  
J-F Lirng ◽  
F-C Chang ◽  
S-J Wang
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Venous Thrombosis ◽  
Intracranial Hypotension ◽  
Venous Blood ◽  
Spontaneous Intracranial Hypotension ◽  
Brain Magnetic Resonance Imaging ◽  
Venous Blood Flow ◽  
Cortical Vein ◽  
Cortical Vein Thrombosis ◽  
Cortical Venous Thrombosis

Spontaneous intracranial hypotension (SIH) associated with subarachnoid haemorrhage (SAH) has never been reported. Here, we report on a case of a 33-year-old woman with SIH, who developed simple partial sensory seizures 3 weeks later. Neuroimaging studies, including brain computed tomography and angiography, were initially normal, but revealed an isolated cortical venous thrombosis at 3 weeks. One week later, brain magnetic resonance imaging showed SAH around the thrombosed cortical vein. We postulate that the decline in the venous blood flow velocity due to SIH may have resulted in cortical venous thrombosis, which in turn led to rupture of the vessel wall and SAH in this patient.

Sonography of the optic nerve sheath diameter before and after microsurgical closure of a dural CSF fistula in patients with spontaneous intracranial hypotension – a consecutive cohort study

Cephalalgia ◽  
2018 ◽  
Vol 39 (2) ◽  
pp. 306-315 ◽  
Author(s):  
Jens Fichtner ◽  
Christian T Ulrich ◽  
Christian Fung ◽  
Debora Cipriani ◽  
Jan Gralla ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Optic Nerve ◽  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension ◽  
Cerebrospinal Fluid Leak ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Cerebrospinal Fluid Leakage ◽  
Nerve Sheath ◽  
Fluid Leak

Objective Spontaneous intracranial hypotension is caused by spinal cerebrospinal fluid leakage. Patients with orthostatic headaches and cerebrospinal fluid leakage show a decrease in optic nerve sheath diameter upon movement from supine to upright position. We hypothesized that the decrease in optic nerve sheath diameter upon gravitational challenge would cease after closure of the leak. Methods We included 29 patients with spontaneous intracranial hypotension and refractory symptoms admitted from 2013 to 2016. The systematic workup included: Optic nerve sheath diameter sonography, spinal MRI and dynamic myelography with subsequent CT. Microsurgical sealing of the cerebrospinal fluid leak was the aim in all cases. Results Of 29 patients with a proven cerebrospinal fluid leak, one declined surgery. A single patient was lost to follow-up. In 27 cases, the cerebrospinal fluid leak was successfully sealed by microsurgery. The width of the optic nerve sheath diameter in supine position increased from 5.08 ± 0.66 mm before to 5.36 ± 0.53 mm after surgery ( p = 0.03). Comparing the response of the optic nerve sheath diameter to gravitational challenge, there was a significant change from before (−0.36 ± 0.32 mm) to after surgery (0.00 ± 0.19 mm, p < 0.01). In parallel, spontaneous intracranial hypotension-related symptoms resolved in 26, decreased in one and persisted in a single patient despite recovery of gait. Conclusions The sonographic assessment of the optic nerve sheath diameter with gravitational challenge can distinguish open from closed spinal cerebrospinal fluid fistulas in spontaneous intracranial hypotension patients. A response to the gravitational challenge, that is, no more collapse of the optic nerve sheath while standing up, can be seen after successful treatment and correlates with the resolution of clinical symptoms. Sonography of the optic nerve sheath diameter may be utilized for non-invasive follow-up in spontaneous intracranial hypotension.

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