An incomplete understanding of the variability of MRI findings resulted in the diagnosis of spontaneous intracranial hypotension being excluded in patients with normal findings.
Prompt diagnosis of the spontaneous intracranial hypotension results in proper treatment, which may be simple in the form of bed rest to epidural blood patch or by spinal tear closure.
CT-guided epidural blood patching of directly observed or potential leak sites for the targeted treatment of spontaneous intracranial hypotension
Spontaneous intracranial hypotension is a rare condition caused by a spontaneous cerebrospinal fluid (CSF) leak; it is often misdiagnosed or under-diagnosed (1).
Clinical suspicion of spontaneous intracranial hypotension syndrome (SIH) is suggested by a history of daily headaches that occur shortly after assuming an upright position and are relieved by lying down.
The syndrome of spontaneous intracranial hypotension is caused by a reduced cerebrospinal fluid (CSF) volume leading to decreased CSF pressure.
Orthostatic headache that improves rapidly in the recumbent position and worsens in the erect position is the classical sign of Spontaneous intracranial hypotension although patients with chronic headaches or even no headaches have been described.
The differential diagnosis for orthostatic headache includes spontaneous intracranial hypotension (as in these cases), postdural puncture (resulting from a lumbar puncture or spinal anesthesia), and CSF fistula.
On MRI of the brain with gadolinium contrast, the classic sign of intracranial hypotension due to a CSF leak is contiguous, pachymeningeal enhancement, Dr.
1) Spontaneous intracranial hypotension
is rare, with a prevalence of approximately 1:50,000 persons, and it is more common in women, with female-male ratio of 3:1.
Diagnostic value of spinal-MR-imaging in spontaneous intracranial hypotension
Key Words: neuroendoscopy, hydrocephalus, iatrogenic complication, intracranial hypotension