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Spontaneous Intracranial Hypotension

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https://www.readbyqxmd.com/read/28504775/efficacy-of-epidural-blood-patches-for-spontaneous-low-pressure-headaches-a-case-series
#1
S Ansel, A Rae, A Tyagi
Patients with a spontaneous cerebrospinal fluid leak, normally at a spinal level, typically present with low-pressure headache. In refractory cases, an epidural blood patch may be attempted. We aimed to assess the efficacy of lumbar epidural blood patching in spontaneous, low-pressure headaches. Methods We retrospectively analysed notes of patients who had an epidural blood patch performed for spontaneous low-pressure headaches in a single centre. Information regarding demographics, radiology and clinic follow-up was extracted from an electronic patient record system...
December 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28466552/greater-occipital-nerve-treatment-in-the-management-of-spontaneous-intracranial-hypotension-headache-a-case-report
#2
G Niraj, Peter Critchley, Mahesh Kodivalasa, Mohammed Dorgham
BACKGROUND: Clinical presentation of spontaneous intracranial hypotension headache (SIHH) has similarities with postdural puncture headache (PDPH). Recommended treatment for both conditions is an epidural blood patch. Successful outcomes following greater occipital nerve blocks have been reported in the management of PDPH. We present the first report of greater occipital nerve treatment in SIHH. METHODS: A 40-year-old male presented with a 2-year history of daily postural headaches having a significant impact on quality of life...
May 2, 2017: Headache
https://www.readbyqxmd.com/read/28433974/hypoactive-hypoalert-behaviour-and-thalamic-hypometabolism-due-to-intracranial-hypotension
#3
Seamus Kearney, Peter Flynn, Simon Hughes, Wendy Spence, Mark Owen McCarron
A 47-year-old man presented with a 9-year history of a hypoalert hypoactive behaviour syndrome, caused by the deep brain swelling variant of spontaneous intracranial hypotension. Along with apathy with retained cognition, he had stable ataxia, impaired upgaze and episodes of central apnoea. MRI brain showed a sagging brainstem, pointed ventricles and reduced angle between the vein of Galen and the straight sinus, but no meningeal enhancement or subdural collections. A dopamine transporter scan showed preganglionic dopamine receptor deficiency; a fluorodeoxy glucose positron emission tomography scan showed bilateral hypothalamic hypometabolism...
April 22, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28419438/dinosaur-tail-sign-a-useful-spinal-mri-finding-indicative-of-cerebrospinal-fluid-leakage
#4
Keita Sakurai, Masafumi Kanoto, Motoo Nakagawa, Masashi Shimohira, Aya M Tokumaru, Masashi Kameyama, Keigo Shimoji, Satoru Morimoto, Noriyuki Matsukawa, Minoru Nishio, Yuta Shibamoto
OBJECTIVE: To evaluate the imaging characteristics and diagnostic utility of the "Dinosaur tail sign" in the diagnosis of cerebrospinal fluid (CSF) leakage. BACKGROUND: The authors propose the "Dinosaur tail sign," defined as a combination of the dorsal epidural hyperintensities, fat tissue, spinal cord, and cauda equine on lumbosacral sagittal fat-suppressed T2-weighted image (FST2WI), as a sensitive indicator for diagnosing CSF leakage. METHODS: Imaging characteristics of the "Dinosaur tail sign" was evaluated in seven spontaneous intracranial hypotension (SIH) and 23 iatrogenic CSF leakage (ICSFL) patients...
April 16, 2017: Headache
https://www.readbyqxmd.com/read/28385881/quantitative-measurement-of-csf-in-patients-with-spontaneous-intracranial-hypotension
#5
H-C Chen, P-L Chen, Y-H Tsai, C-H Chen, C C-C Chen, J-W Chai
BACKGROUND AND PURPOSE: CSF hypovolemia is a core feature of spontaneous intracranial hypotension. Spontaneous intracranial hypotension is characterized by orthostatic headache and radiologic manifestations, including CSF along the neural sleeves, diffuse pachymeningeal enhancement, and/or venous engorgement. However, these characteristics are only qualitative. Quantifying intraspinal CSF volumes could improve spontaneous intracranial hypotension diagnosis and evaluation of hypovolemic statuses in patients with spontaneous intracranial hypotension...
April 6, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28357166/spontaneous-intracranial-hypotension-presenting-as-a-pseudo-chiari-1
#6
Ali S Haider, Suraj Sulhan, Ian T Watson, Dean Leonard, Eliel N Arrey, Umair Khan, Phu Nguyen, Kennith F Layton
Spontaneous intracranial hypotension (SIH) is classified as a decrease in cerebrospinal fluid (CSF) pressure secondary to a CSF leakage and consequent descent of the brain into the foramen magnum. Diagnosing SIH can be difficult due to its overlapping findings with Arnold-Chiari type 1 Malformation (CM1) where the cerebellar tonsils herniate into the foramen magnum. The similarity of both conditions calls for a more reliable imaging technique to localize the CSF leak which could narrow the differential diagnosis and aid in choosing the correct treatment...
February 16, 2017: Curēus
https://www.readbyqxmd.com/read/28355333/intracranial-hypotension-secondary-to-spontaneous-spinal-cerebrospinal-fluid-leaks
#7
Antonio Eustáquio Silva, Patricia Pavan, Mariana Mari Oshima, Tânia Marchiori de Oliveira Cardoso, Fabiano Reis
No abstract text is available yet for this article.
March 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28348118/spontaneous-intracranial-hypotension-diagnosed-as-chiari-i-malformation
#8
William Kingston, Joseph Hoxworth, Rashmi Halker-Singh
No abstract text is available yet for this article.
March 28, 2017: Neurology
https://www.readbyqxmd.com/read/28283371/chiari-like-displacement-due-to-spontaneous-intracranial-hypotension-in-an-adolescent-successful-treatment-by-epidural-blood-patch
#9
Jan Schönberger, Markus Möhlenbruch, Angelika Seitz, Cornelia Bußmann, Heidi Bächli, Stefan Kölker
BACKGROUND: Spontaneous intracranial hypotension is a rarely diagnosed cause of headache, especially in children and adolescents. It is due to cerebrospinal fluid (CSF) leakage via spinal fistulae occurring without major trauma. CASE PRESENTATION: An adolescent patient presented with a 3-month history of strictly postural headache. Cranial magnetic resonance imaging (MRI) showed pronounced Chiari-like prolapse of the cerebellar tonsils, narrow ventricles and enlarged cerebral veins...
February 20, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28254591/a-small-leak-will-sink-the-brain-targeted-c1-c2-patching
#10
Thomas Decramer, Pieter Jan Van Dyck-Lippens, Tom P Franken, Philippe Demaerel, Johannes van Loon, Tom Theys
BACKGROUND: Spontaneous intracranial hypotension syndrome results from spontaneous spinal cerebrospinal fluid (CSF) leaks. The first treatment of choice consists of lumbar epidural blood patching. If this fails, further imaging is mandatory to explore the possibility of targeted therapy. CASE DESCRIPTION: We describe a case of a 50-year-old woman who developed spontaneous intracranial hypotension after minor blunt cervical trauma, complicated with bilateral subdural hematomas...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28202822/-idiopathic-intracranial-hypotension
#11
Iwao Takeshita, Satoshi O Suzuki, Toru Iwaki
Idiopathic intracranial hypotension (hypovolemia) is almost exclusively provoked by cerebrospinal fluid (CSF) leakage through spontaneously rent dural sac. An initial clinical feature of a severe headache with or without nausea/vomiting should be differentiated from a life-threatening stroke. An early diagnosis and proper therapy may guarantee a good outcome, while delays may promote complicated manifestations and irreversible poor outcome in a few patients. In this article, neuro-imaging studies of some demonstrable cases are presented and the outlets of the spinal CSF and spinal CSF pathways are shown with immunohistological staining...
February 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28192268/spontaneous-intracranial-hypotension-a-review-and-introduction-of-an-algorithm-for-management
#12
REVIEW
Benjamin Davidson, Farshad Nassiri, Alireza Mansouri, Jetan H Badhiwala, Christopher D Witiw, Mohammed F Shamji, Philip W Peng, Richard I Farb, Mark Bernstein
BACKGROUND: Spontaneous intracranial hypotension (SIH) is a condition of low cerebrospinal fluid volume and pressure caused by a leak of cerebrospinal fluid through a dural defect. Diagnosis and management can be difficult, often requiring coordination between multiple disciplines for myelography, blood patching, and possible surgical repair. Patients should be monitored closely, because they can deteriorate into a coma or even death. There are no widely accepted guidelines for the management of SIH...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28130464/spinal-meningeal-diverticula-spontaneous-intracranial-hypotension-and-superficial-siderosis
#13
Wouter I Schievink, M Marcel Maya
No abstract text is available yet for this article.
February 28, 2017: Neurology
https://www.readbyqxmd.com/read/28110544/intracranial-structural-alteration-predicts-treatment-outcome-in-patients-with-spontaneous-intracranial-hypotension
#14
Hanna Choi, Mi Ji Lee, Hyun Ah Choi, Jihoon Cha, Chin-Sang Chung
Background Intracranial structural dislocation in spontaneous intracranial hypotension (SIH) can be measured by various intracranial angles and distances. We aimed to identify the clinical significance of structural dislocation in relation to treatment outcome in patients with SIH. Methods In this retrospective analysis, we identified patients with SIH who received an epidural blood patch (EBP) at Samsung Medical Center from January 2005 to March 2015. Structural dislocation in pretreatment MRIs of SIH patients was assessed by measuring tonsillar herniation, mamillopontine distance, the angle between the vein of Galen and straight sinus (vG/SS angle), the pontomesencephalic angle, and the lateral ventricular angle...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28091819/the-status-of-diagnosis-and-treatment-to-intracranial-hypotension-including-sih
#15
REVIEW
Jin-Ping Lin, Shu-Dong Zhang, Fei-Fang He, Min-Jun Liu, Xiao-Xu Ma
Intracranial hypotension, especially spontaneous intracranial hypotension (SIH), is a well-recognized entity associated with cerebrospinal fluid (CSF) leaks, and has being recognized better in resent years, while still woefully inadequate. An increasing number of factors including iatrogenic factors are realized to involve in development and progression of intracranial hypotension. The diagnosis remains difficult due to the various clinical manifestations, some of which are nonspecific and easily to be neglected...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28079571/spontaneous-intracranial-hypotension-with-site-of-leak-detected-only-after-111in-dtpa-cisternogram
#16
Sana Parsian, Manuela C Matesan, Sachin Shivaji Kumbhar, David H Lewis
A 54-year-old man with a 3-week history of orthostatic headache and acute on chronic subdural hematoma presented with imaging findings suggestive of spontaneous intracranial hypotension. Three myelograms were negative for leak, and nontargeted epidural blood patches did not result in symptom relief. A cerebrospinal fluid leak study using In-DTPA with SPECT/CT demonstrated a focal area of asymmetric activity at the left C2 nerve root. A left C2 root tie-off, targeted epidural blood patch, and Dura seal glue resulted in resolution of patient symptomatology highlighting the importance of fused SPECT/CT images in detection of an occult cerebral spinal fluid leak...
April 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28057591/surgical-management-of-spontaneous-spinal-cerebrospinal-fluid-epidural-fistula
#17
Declan G Siedler, Imogen M Ibbett, Nova B Thani
BACKGROUND: Intracranial hypotension secondary to spontaneous spinal cerebrospinal fluid (CSF) fistula is a rare condition that can have serious sequelae. Early diagnosis and treatment can be challenging. CASE DESCRIPTION: We present the case of a 17-year-old male who presented with a history of sudden-onset, postural headaches associated with upper thoracic back pain. Magnetic resonance imaging (MRI) demonstrated a thoracic extradural fluid collection and slumping of the brain within the posterior fossa...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28043956/factors-predicting-response-to-the-first-epidural-blood-patch-in-spontaneous-intracranial-hypotension
#18
Jr-Wei Wu, Shu-Shya Hseu, Jong-Ling Fuh, Jiing-Feng Lirng, Yen-Feng Wang, Wei-Ta Chen, Shih-Pin Chen, Shuu-Jiun Wang
Spontaneous intracranial hypotension results from cerebrospinal fluid leakage. Currently, the treatment of choice for spontaneous intracranial hypotension is the epidural blood patch, which has a variable response rate and no clear outcome predictors. This study aimed to identify predictors for response rate of a first targeted epidural blood patch in patients with spontaneous intracranial hypotension. We reviewed cases of patients with spontaneous intracranial hypotension who received targeted epidural blood patch at our hospital between 1 January 2007 and 1 July 2014...
February 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/27994919/frequency-of-nerve-root-sleeve-cysts-in-autosomal-dominant-polycystic-kidney-disease
#19
Murat Aşık, Fatih Tufan, Timur Selçuk Akpınar, Nilgül Akalın, Elvan Ceyhan, Necmeddin Tunç, Zehra Işık Hasıloğlu, Mehmet Rıza Altıparmak, Tevfik Ecder, Sait Albayram
BACKGROUND: There is sporadic data about the occurrence of spinal meningeal cysts in patients with autosomal dominant polycystic kidney disease (ADPKD). We suggest that there is a relationship with the frequency and size of spinal meningeal cysts and headache, intracranial aneurysms, and cerebrospinal fluid leakage in patients with ADPKD. AIM: To investigate the relationship with spinal meningeal cyst, cerebrospinal fluid leakage, and headache in patients with ADPKD...
November 2016: Balkan Medical Journal
https://www.readbyqxmd.com/read/27943273/granulomatosis-with-polyangiitis-associated-hypertrophic-pachymeningitis-mimicking-spontaneous-intracranial-hypotension-a-case-report
#20
Young Hee Jung, Mi Ji Lee, Chungbin Lee, Jihoon Cha, Chin-Sang Chung
BACKGROUND: Dural enhancement is a characteristic finding in both spontaneous intracranial hypotension and hypertrophic pachymeningitis. Positional headache is the most important feature that distinguishes the two diseases. We report a patient with granulomatosis with polyangiitis (formerly Wegener's granulomatosis) who initially manifested like spontaneous intracranial hypotension. CASE PRESENTATION: We report here the case of a 63-year old man who presented with severe positional headache...
March 2017: Headache
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