O030. Treatment of orthostatic headache from spontaneous intracranial hypotension syndrome: single institutional experience of 326 cases

Management of Spontaneous Intracranial Hypotension During Pregnancy: A Case Series

“…SIH during pregnancy is a rare condition; in our series of over 400 patients, it was reported in 5 (1.2%) cases 18 . All participants gave written informed consent and ethics board approval was required and obtained for describing this case series.…”

Postural Headache? It’s Not a Tumor!

“…4 Headaches typically resolve immediately with an epidural blood patch, although that timing does not fit with the presumed pathophysiology. 4,6,16 MRI performed after an epidural blood patch does show that the epidural clot extends primarily cephalad approximately 3 to 5 spinal segments. 17 If unsuccessful, the epidural blood patch can be repeated with larger volumes of 20 to 100 mL.…”

“…Rarely, SIIH may result in more severe symptomatology, such as cerebral vein thrombosis, spontaneous subdural hemorrhage, and even coma. 6 The key feature on history is the positional nature of the headache. Making this diagnosis more difficult, the positional component may become inconsistent over time.…”

“…If the lumbar EBP is unsuccessful, they perform MRI or CT myelogram to try to identify the leak to perform an epidural blood patch directed to that site. 4,6 Others perform MRI or CT myelogram first and start with a directed epidural blood patch. 16 In rare cases, open evaluation is necessary to surgically close the dural tear.…”

Intracranial Hypotension Following Traumatic Brain Injury: A Diagnostic and Therapeutic Challenge

“…Another method of treating SIH is placing the patient in trendelenberg position. Ferrante et al reported treating SIH with a combination of EBP and trendelenberg position with a success rate of approximately 99% [3].…”