Intracranial hypotension syndrome: neuroimaging in five spontaneous cases and etiopathogenetic correlations

Intracranial hypotension (IH) is essential or, more frequently, secondary. This syndrome is characterized by severe postural headache and low opening cerebrospinal fluid (CSF) pressure; although other symptoms may exist. In this study five patients are investigated. Neuroimaging showed: on computeri...

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Bibliographic Details
Published in:Clinical neurology and neurosurgery 1998-03, Vol.100 (1), p.33-39
Main Authors: Ferrante, Enrico, Riva, Maurizio, Gatti, Antonella, Brioschi, Andrea Mauro, Guccione, Angelo, Colombo, Nadia, Vanini, Marco, Veronese, Silvio
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Brain - diagnostic imaging
Brain - pathology
Cerebrospinal Fluid Pressure
Computerized tomography scan
Diagnosis, Differential
Female
Headache - etiology
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Intracranial Hypotension - diagnosis
Intracranial Hypotension - etiology
Intracranial Hypotension - pathology
Magnetic Resonance Imaging
Male
Medical sciences
Meningeal enhancement
Middle Aged
Nervous system (semeiology, syndromes)
Neurology
Posture
Spontaneous intracranial hypotension
Syndrome
Tomography, X-Ray Computed
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Summary:Intracranial hypotension (IH) is essential or, more frequently, secondary. This syndrome is characterized by severe postural headache and low opening cerebrospinal fluid (CSF) pressure; although other symptoms may exist. In this study five patients are investigated. Neuroimaging showed: on computerized tomography scan (CT), poor visualization of the cerebral sulci with small ventricles; on magnetic resonance imaging (MRI), subdural fluid collections with enhancement on the convexity, along the tentorium and in the upper cervix after administration of contrast medium and downward displacement of the brain. Radionuclide cisternography was normal in the two patients who underwent this treatment as well as the meningeal biopsy in another patient. In all patients the opening CSF pressure was low or unmeasurable. The clinical syndrome spontaneously recovered contextually to normalization of neuroradiological findings. The possible pathogenesis (dural border cell layer tear) was discussed and the importance of diagnostic confirmation with MRI and measurement of CSF pressure when IH is thought to be present was underlined.
ISSN:0303-8467
1872-6968
DOI:10.1016/S0303-8467(97)00107-8