BACKGROUND AND PURPOSE Spontaneous intracranial hypotension (SIH) presents with orthostatic headache, and the diagnosis is made on the basis of low CSF pressure and brain MR imaging findings characteristic of the disorder. However, a broad spectrum of symptoms and MR imaging findings of SIH is recognized, and some cases have no typical MR imaging abnormalities. SIH is believed to be caused by C...

Spontaneous Intracranial Hypotension (SIH) was first described over 60 years ago by Schaltenbrand and termed “aliquorrhea”1. In 1997, this syndrome was defined by a classical triad of postural headaches, low cerebral spinal fluid (CSF) pressure and imaging abnormalities2. More recent evidence has redefined this concept and our understanding of the pathological mechanism, as well as the variable...

UNLABELLED Radionuclide cisternography is an indispensable examination to detect cerebrospinal fluid (CSF) leakage in patients suspected of having spontaneous intracranial hypotension (SIH). However, it sometimes fails to demonstrate the site of CSF leakage, and in such cases, early bladder visualization is utilized for the diagnosis of SIH as an indirect finding. The aim of this work is to imp...

Received 9/30/2003; revised 10/25/2003; accepted 11/1/2003. For correspondence or reprints contact: Chien-Chin Hsu, M.D., Department of Nuclear Medicine, Chung-Ho Memorial Hospital, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung 807, Taiwan. Tel: (886)7-3121101 ext. 7152, Fax: (886)7-3117521, E-mail: [email protected] Spontaneous intracranial hypotension (SIH), by definition, is spo...

BACKGROUND Patients with chronic postural headaches may suffer from spontaneous intracranial hypotension (SIH). Trauma, degenerative disc spurring and connective tissue disorders are documented risk factors; in most cases there is no inciting event. Despite sophisticated means of evaluating the neuraxis, many cerebrospinal fluid (CSF) leaks are radiographically occult and treatment is focused o...

X.-L. Tan, MD, PhD Q.-D. Yang, MD, MSc X.-J. Liu, MD B. Xiao, MD, PhD B.-S. Tang, MD A 39-year-old woman developed orthostatic headache. Cranial MRI indicated spontaneous intracranial hypotension (SIH) (figure, A). Spinal MRI suggested CSF leaks at C1–2, C2–3, and C5–6 levels (figure, B and C), but both radionuclide cisternography and CT myelography (immediate and 3-hour delayed scanning) showe...

Spontaneous intracranial hypotension (SIH) due to spinal cerebrospinal fluid (CSF) leaks is becoming increasingly recognized as a cause of headache in adults.1 A combination of minor trauma and developmentally ‘weak’ meninges has been considered to be responsible for some cases.1,2 There is also an association with autosomal dominant polycystic kidney disease, neurofibromatosis type 1, Marfan a...

Headache is one of the most common clinical entities, and has a long list of differential diagnoses; however, one of the more uncommon causes of postural headache is spontaneous intracranial hypotension. It is important that clinicians be aware of this condition, as it is often overlooked, leading to invasive and unnecessary diagnostic testing. A good history and physical exam, paired with an M...

Spontaneous intracranial hypotension (SIH) has increasingly been recognized, and it is well known that SIH is sometimes complicated by chronic subdural hematoma (SDH). In this study, 55 cases of SIH with SDH were retrospectively analyzed, focusing on therapeutic strategies and outcomes. Of 169 SIH cases (75 males, 84 females), 55 (36 males, 19 females) were complicated by SDH. SIH was diagnosed...