Spontaneous intracranial hypotension: report of two cases and review of the literature.

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  • Author(s): Rando TA;Rando TA; Fishman RA
  • Source:
    Neurology [Neurology] 1992 Mar; Vol. 42 (3 Pt 1), pp. 481-7.
  • Publication Type:
    Case Reports; Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0401060 Publication Model: Print Cited Medium: Print ISSN: 0028-3878 (Print) Linking ISSN: 00283878 NLM ISO Abbreviation: Neurology Subsets: MEDLINE
    • Publication Information:
      Publication: Hagerstown, MD : Lippincott Williams & Wilkins
      Original Publication: Minneapolis.
    • Subject Terms:
      Cerebrospinal Fluid Pressure*; Brain Diseases/*diagnosis; Adult ; Brain Diseases/diagnostic imaging ; Cerebrospinal Fluid ; Female ; Headache/etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myelography ; Radionuclide Imaging
    • Abstract:
      We report two patients with spontaneous intracranial hypotension. In addition to the cardinal features of a postural headache and a low CSF pressure, the patients also had subdural fluid collections demonstrated by head MRI. In both patients, radionuclide cisternography revealed a CSF leak along the spinal axis and rapid accumulation of radioisotope in the bladder. CSF leakage from spinal meningeal defects may be the most common cause of this syndrome. The headache is a consequence of the low CSF pressure producing displacement of pain-sensitive structures. Associated symptoms, including tinnitus and vertigo, and subdural fluid collections are presumably from hydrostatic changes among intracranial fluid compartments that occur at low CSF pressures. Methods of treatment are identical to those for post-dural puncture headaches. Epidural blood patches and epidural saline infusions have rapidly ameliorated the symptoms of spontaneous intracranial hypotension.
    • Comments:
      Comment in: Neurology. 1993 May;43(5):1060-1. (PMID: 8347193)
      Comment in: Neurology. 1993 May;43(5):1060; author reply 1061. (PMID: 8492932)
    • Publication Date:
      Date Created: 19920301 Date Completed: 19920423 Latest Revision: 20220408
    • Publication Date:
      20231215
    • Accession Number:
      10.1212/wnl.42.3.481
    • Accession Number:
      1549206