A Review of Spontaneous Intracranial Hypotension

Upadhyaya, Parth; Ailani, Jessica

doi:10.1007/s11910-019-0938-7

Cited by 29 publications

(95 citation statements)

References 49 publications

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“…For patients who do not adequately respond to a conservative approach, injection of autologous blood into the spinal epidural space is the preferred invasive treatment. The success rate for each EBP varies from 30-70% for non-targeted patching, and up to 87% for targeted patching [2,5,6,9].…”

Section: Discussionmentioning

confidence: 99%

“…Spontaneous intracranial hypotension (SIH) is an uncommon but treatable cause of secondary headaches, with an estimated annual incidence of 5 per 100,000 individuals [1,2]. The most common symptom of SIH is an orthostatic headache which appears shortly after becoming upright and improves or disappears after lying down.…”

Section: Introductionmentioning

confidence: 99%

“…These symptoms may develop rapidly after the EBP or over a period of days or weeks, but they commonly begin within the rst 36 hours [8,9]. It is important to differentiate this rebound phenomenon from unimproved SIH, as the treatment options will differ [2].…”

Section: Introductionmentioning

confidence: 99%

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Early and Delayed Rebound Intracranial Hypertension Following Epidural Blood Patch in a Case of Spontaneous Intracranial Hypotension: A Case Report

Jafari

Karaminia

Togha

2021

Preprint

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Background: Spontaneous intracranial hypotension (SIH) is a secondary headache that has been attributed to a cerebrospinal fluid (CSF) leak. It may resolve spontaneously or require conservative treatment. An epidural blood patch (EBP) with autologous blood is performed in cases exhibiting an inadequate response to conservative methods. Rebound intracranial hypertension (RIH) can develop following an EBP in up to 27% of patients. It is characterized by a change in the headache features and is often accompanied by nausea, blurred vision. and diplopia. Symptoms commonly begin within the first 36 hours, but could develop over days to weeks. It is important to differentiate this rebound phenomenon from unimproved SIH, as the treatment options differ. Case presentation: Here we present an interesting case of a patient with SIH who was treated with EBP and developed both immediate RIH after 24 hours and delayed RIH 3 weeks following EBP. Conclusions: Following EBP for treatment of SIH, new onset of a headache having a different pattern and location should always be monitored for the occurrence of a RIH. A lumbar puncture should be done if the symptoms of elevated CSF pressure become intolerable or if the diagnosis is uncertain. Lack of early diagnosis and treatment and differentiation from SIH can cause complications and could affect the optic nerves.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early and Delayed Rebound Intracranial Hypertension Following Epidural Blood Patch in a Case of Spontaneous Intracranial Hypotension: A Case Report

Jafari

Karaminia

Togha

2021

Preprint

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“…Otro mecanismo es la formación de colecciones subdurales supratentoriales bilaterales simétricas, con o sin hemorragia asociada; éstas pueden alcanzar volúmenes significativos, e incluso llevar a una errónea atribución de la sintomatología. Eventualmente el descenso tronco encefálico puede llegar a la compresión y herniación a través del foramen magno, con alta morbi-mortalidad 17 .…”

Section: Discussionunclassified

Ectasia dural e hipotensión endocraneal en síndrome de Marfán

Pichott

Bernstein

et al. 2020

Rev Chil Pediatr

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Introducción: El síndrome de Marfán es un trastorno multisistémico del tejido conectivo de herencia autosómica dominante, de expresión variable. La ectasia dural es un compromiso frecuente, pero poco conocido, que puede asociarse a síndrome de hipotensión endocraneana (SHE).Objetivo: Presentar un caso de cefalea invalidante secundario a SHE, para advertir de esta rara complicación, que debe tenerse presente en niños portadores de conectivopatías, en especial síndrome de Marfán.Caso Clínico: Adolescente femenina de 13 años, portadora de sindrome de Marfán, de diagnóstico clínico según criterios de Ghent 2010, que consultó por cefalea ortostatica invalidante de 6 meses de evolución. La Resonancia Magnetica (RM) de cerebro mostró múltiples signos de hipotensión endocraneana, mientras que la RM de columna total mostró una ectasia dural que determinó la dilatación del saco tecal y remodelación posterior de los cuerpos vertebrales, especialmente a nivel del sacro. Se realizó tratamiento con parche sanguíneo autólogo epidural con buena respuesta clínica.Conclusiones: La ectasia dural, frecuente en el sindrome de Marfán, es una causa predisponente a fuga de líquido cefaloraquideo (LCR), que podría causar cefalea ortostática segundaria al SHE.

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“…Spontaneous intracranial hypotension caused by leakage of cerebrospinal fluid (CSF), is a major cause of postural headache 510). Although connective tissue diseases, trauma, and spinal procedure-related injuries are mainly associated with pathogenesis, the pathogenesis of spontaneous CSF leakage remains unclear 21012)…”

Section: Introductionmentioning

confidence: 99%

Cervical Cerebrospinal Fluid Leakage Concomitant with a Thoracic Spinal Intradural Arachnoid Cyst

Han

Choi

Park

et al. 2019

Korean J Neurotrauma

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We encountered a very rare case of spontaneous spinal cerebrospinal fluid (CSF) leakage and a spinal intradural arachnoid cyst (AC) that were diagnosed at different sites in the same patient. These two lesions were thought to have interfered with the disease onset and deterioration. A 30-year-old man presented with sudden neck pain and orthostatic headache. Diplopia, ophthalmic pain, and headache deteriorated. CSF leakage was confirmed in C2 by radioisotope cisternography, and an epidural blood patch was performed. While his symptoms improved gradually, paraparesis suddenly progressed. Thoracolumbar magnetic resonance imaging (MRI) revealed an upper thoracic spinal intradural AC, which was compressing the spinal cord. We removed the outer membrane of the AC and performed fenestration of the inner membrane after T3-4 laminectomy. Postoperative MRI showed complete removal of the AC and normalized lumbar subarachnoid space. All neurological deficits including motor weakness, sensory impairment, and voiding function improved to normal. We present a case of spontaneous spinal CSF leakage and consecutive intracranial hypotension in a patient with a spinal AC. Our report suggests that if spinal CSF leakage and a spinal AC are diagnosed in one patient, even if they are located at different sites, they may affect disease progression and aggravation.

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A Review of Spontaneous Intracranial Hypotension

Cited by 29 publications

References 49 publications

Early and Delayed Rebound Intracranial Hypertension Following Epidural Blood Patch in a Case of Spontaneous Intracranial Hypotension: A Case Report

Early and Delayed Rebound Intracranial Hypertension Following Epidural Blood Patch in a Case of Spontaneous Intracranial Hypotension: A Case Report

Ectasia dural e hipotensión endocraneal en síndrome de Marfán

Cervical Cerebrospinal Fluid Leakage Concomitant with a Thoracic Spinal Intradural Arachnoid Cyst

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