Spontaneous intracranial hypotension (SIH) is a syndrome characterized by low cerebrospinal fluid (CSF) pressure and postural headaches. It is a rare condition which may sometimes present with severe symptoms such as stupor or coma. The standard treatment protocol includes conservative measures such as bed rest, hydration, and steroids. However, severe cases may require invasive measures such a...

BACKGROUND Spontaneous intracranial hypotension (SIH) has become a well-recognized syndrome. However, diagnosis of SIH is still challenging. The problem with SIH is that the precise mechanism of cerebrospinal fluid (CSF) leakage remains largely unknown and there is no definite diagnostic criterion in the imaging. METHODS The clinical findings of our ten cases and 301 literature reports on SIH...

A literature search found no clinical trials or guidelines addressing the management of spontaneous intracranial hypotension (SIH). Based on the available literature and expert opinion, we have developed recommendations for the diagnosis and management of SIH. For typical cases, we recommend brain magnetic resonance (MR) imaging with gadolinium to confirm the diagnosis, and conservative measure...

PURPOSE Spontaneous intracranial hypotension (SIH) is a rare type of headache. The association of SIH with malignancy and disseminated intravascular coagulation (DIC) has not previously been reported. CASE REPORT A 60-year-old woman had orthostatic headache for more than one month before admission. MRI of brain showed diffuse pachymeningeal enhancement with bilateral subdural hematoma. MR mye...

The subdural hematoma (SDH) could be a serious complication of the spontaneous intracranial hypotension (SIH) that is a rare but well-known entity. We reported four illustrative cases of subdural hematomas revealing SIH. Three women and a man with mean age of 58.5 years. In three cases we noted sudden headaches, progressive and postural in one. CT scan has diagnosed the subdural hematomas that ...

Abstract Background Spontaneous intracranial hypotension (SIH) is characterized by positional headache caused low CSF pressure, without any major traumatic event. Optimal treatment still debated; epidural blood patch (EBP) usually used after unsuccessful conservative with variable efficacy and potentially severe complications. Although steroids have been reported to be beneficial, their effecti...

BACKGROUND AND PURPOSE Atypical clinical presentations of spontaneous intracranial hypotension include obtundation, memory deficits, dementia with frontotemporal features, parkinsonism, and ataxia. The purpose of this study was to compare clinical and imaging features of spontaneous intracranial hypotension with typical-versus-atypical presentations. MATERIALS AND METHODS Clinical records and...

Objective: Spontaneous intracranial hypotension (SIH) remains a rare and difficult clinical entity to diagnose treat. Epidural blood patch (EBP) of the dural sac is mainstay definitive treatment for refractory cases has mixed efficacy. We sought evaluate recent efficacy outcomes EBP SIH at our institution. Methods: Twenty-three patients (14 women, 9 men, mean age 49) were seen treated between S...

Patients with intracranial hypotension may present with the classic postural headache and a broad spectrum of symptoms including nausea, vomiting, neck pain, visual and hearing disturbances, and vertigo. These various clinical presentations may lead to misdiagnosis of intracranial hypotension, thus delaying effective treatment. SIH is characterized by headache worse on standing , relieved on ly...

BACKGROUND AND PURPOSE Spinal meningeal diverticula have been implicated in the pathogenesis of spontaneous intracranial hypotension and have been proposed as both diagnostic features of and therapeutic targets for the condition. We compared the prevalence and myelographic appearance of spinal diverticula in patients with SIH and healthy controls. MATERIALS AND METHODS Patients satisfying the...