Misdiagnosis of Spontaneous Intracranial Hypotension

Abstract

Patients with spontaneous intracranial hypotension are commonly misdiagnosed, causing a significant delay in the initiation of effective treatments and exposing patients to the risks associated with treatment for disorders that mimic intracranial hypotension. Increasing the awareness of this spontaneous type of intracranial hypotension is required to decrease the high rate of misdiagnosis.

Frequency of spontaneous intracranial hypotension in the emergency department

“…Our study is also limited by the nature of its use of an ED setting. Although most patients with spontaneous intracranial hypotension visit an ED during the course of their illness [2], this is not a universal occurrence, affecting its comparison to the incidence of SAH. An additional limitation is that not all patients with a main complaint of headache were identified, affecting the estimate of spontaneous intracranial hypotension among all patients with headache in the ED.…”

“…The clinical hallmark of spontaneous intracranial hypotension is the presence of a headache that is exacerbated by the upright position and relieved by ***recumbancy. Such a characteristic positional component is present, at least initially, in the great majority of patients but misdiagnosis remains common [2]. The headache of spontaneous intracranial hypotension is not always orthostatic and various other headache patterns have been described.…”

Spontaneous Intracranial Hypotension Presenting Without Orthostatic Headache Complicated by Acute Subdural Hematoma After Drainage for Chronic Subdural Hematoma-Case Report-

“…Delay in the diagnosis of SIH is not uncommon, 14) and patients with CSDH may be the most vulnerable: SIH is often associated with CSDH on imaging studies, and SIH patients may have undergone repeated drainages before definitive diagnosis is made. 2,4,11,19) The incidence of CSDH among SIH patients ranges from 20% to 40%.…”

Subdural Effusions in the Posterior Fossa Associated with Spontaneous Intracranial Hypotension

“…2 However, failure to diagnose this condition is still a problem and may have serious consequences. 3,4 The clinical manifestations are varied 2,3,5 and the diagnosis of spontaneous intracranial hypotension may not be obvious in patients with headache.We treated three patients with spontaneous intracranial hypotension, two of whom were referred to our hospital with incorrect diagnoses. All three patients had subdural fluid ABSTRACT: Background: Misdiagnosis of spontaneous intracranial hypotension remains a problem, despite increasing recognition.…”

“…2 However, failure to diagnose this condition is still a problem and may have serious consequences. 3,4 The clinical manifestations are varied 2,3,5 and the diagnosis of spontaneous intracranial hypotension may not be obvious in patients with headache.…”