Diagnosis and treatment of spontaneous intracranial hypotension due to cerebrospinal fluid leakage

Zheng, Yanan; Lian, Yajun; Wu, Chuanjie; Chen, Chen; Zhang, Haifeng; Zhao, Peng

doi:10.1186/s40064-016-3775-z

Cited by 6 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Treatment progresses to autogolous injection of 15 to 20 mL of blood into the epidural space in order to promote repair of the dura deficit by coagulants in the blood [28]. This approach is successful in 90% of cases [25,29], as it was in this case.…”

Section: Discussionmentioning

confidence: 89%

An unusual postural headache: a case report

Pollard¹,

Pollard²

2020

Chiropr Man Therap

View full text Add to dashboard Cite

Background This paper presents a case of an evolving unusual thunderclap headache that presented to a chiropractor. Case presentation The intense “migraine-like” headache was aggravated by standing up and relieved substantially when lying down. This low pressure, orthostatic headache was diagnosed as a spontaneous intracranial hypotension (SIH) secondary to a spontaneous tear of the dura. It was referred to the local hospital for management with autogolous blood injection to form an epidural blood patch of the defect. It resolved substantially within 3 days. Conclusions The significance of key features in the history and examination and how if not recognised and subsequently treated with manual therapy, the dural tear could be attributed to the treatment of the chiropractor, a treatment that would typically involve cervical manipulation. Discussion is provided of the implications of a missed diagnosis and possible subsequent chiropractic management with the evolving SIH being attributed to the chiropractic intervention rather than its true “spontaneous” nature.

show abstract

Section: Discussionmentioning

confidence: 89%

An unusual postural headache: a case report

Pollard¹,

Pollard²

2020

Chiropr Man Therap

View full text Add to dashboard Cite

show abstract

“…The same authors stated that a 2-week bed rest is sufficient time to control that disease, whereas other authors stated that conservative treatment alone could not be effective. [ 15 , 19 , 24 ] Such discrepancies are caused by the difficulty in fulfilling the bed rest recommendation precisely. Patients in stable condition can experience deterioration very quickly or even go to critical due to cerebral wedging, caused by intracranial hypotension.…”

Section: Discussionmentioning

confidence: 99%

Original technique of sealing cerebrospinal fluid leakage from dural sac causing spontaneous cerebral hypotension

Ząbek

2022

Surgical Neurology International

View full text Add to dashboard Cite

Background: Spontaneous intracranial hypotension (SIH) is a rare disease characterized by a decrease in the volume and pressure of cerebrospinal fluid (CSF) resulting from its leakage through the dura mater. SIH is curable, but it can lead to serious clinical sequelae or even death if not treated properly. Case Description: A 37-year-old female with headaches occurring in standing position and increasing especially during verticalization. Magnetic resonance imaging showed an image characteristic of SIH. Conservative treatment was applied in the form of bed rest. CT myelography scan located the site of CSF leakage. As the conservative treatment proved inefficient, it was decided to perform an epidural fistula sealing using the patient’s venous blood, administered under computed tomography guidance. The performed procedure completely resolved the patient’s complaints, allowing her to be discharged home. Conclusion: Patients with suspected SIH should remain in the supine position until a definitive diagnosis is made. Sealing the meningeal fistula with venous blood under computed tomography guidance should be considered in case of conservative treatment failure.

show abstract

“…No clear guidelines have been published with regard to the conservative management of IH. While according to some authors an approximately two-week bed rest is sufficient to control this condition [8,9], some published evidence suggests that conservative treatment might not be enough [10]. The most likely reason behind these discrepancies is patient non-compliance with the bed regime.…”

Section: Casementioning

confidence: 99%