Spontaneous Intracranial Hypotension in the Absence of Magnetic Resonance Imaging Abnormalities

Canadian Journal of Neurological Sciences - Tập 29 Số 3 - Trang 253-257 - 2002
Kerrie Schoffer1, Timothy Benstead1, Ian Grant1
1Division of Neurology, Dalhousie University, Halifax, NS, Canada

Tóm tắt

Background:Spontaneous intracranial hypotension (SIH) is a neurologic syndrome of unknown etiology, characterized by features of low cerebral spinal fluid (CSF) pressure, postural headache and magnetic resonance imaging (MRI) abnormalities.Methods:Four symptomatic cases of SIH presented to our institution over a six-month period. Magnetic resonance imaging studies were performed in all four cases. Diagnostic lumbar puncture was done in all except one case.Results:All of the patients on whom lumbar punctures were performed demonstrated low CSF pressure and CSF protein elevation with negative cultures and cytology. Three out of the four patients exhibited MRI findings of diffuse spinal and intracranial pachymeningeal gadolinium enhancement and extradural or subdural fluid collections. One patient had no MRI abnormalities despite prominent postural headache and reduced CSF pressure at lumbar puncture. All patients recovered with intravenous fluids and conservative treatment.Conclusion:Magnetic resonance imaging abnormalities are found in most, but not all patients, with SIH. Cerebral spinal fluid abnormalities can be detected even in patients with normal MRI studies. It is important to recognize the variability of imaging results in this usually benign disorder.

Từ khóa


Tài liệu tham khảo

10.1097/00000542-199610000-00030

10.1136/jnnp.59.5.511

10.1136/jnnp.55.10.975

10.3171/jns.2000.92.3.0475

10.1097/00000658-196811000-00011

10.1212/WNL.51.6.1768

10.3171/jns.1989.70.5.0808

Ferrante, 1998, Transient oculomotor cranialnerves palsy in spontaneous intracranial hypotension, J Neurosurg Sci, 42, 177

10.1212/WNL.43.12.2698

10.1046/j.1526-4610.2000.00072.x

Fishman, 1997, Intracranial hypotension, J Neurosurg, 86, 165

10.1097/00000542-198606000-00028

10.1001/archneur.56.7.869

10.1016/S0140-6736(99)80013-0

10.1016/0304-3959(87)90185-0

10.1097/00000542-198805000-00020

Hughson, 1932, A note on the relationship of cerebrospinal andintralabyrinthine pressures, Am J Physiol, 101, 396, 10.1152/ajplegacy.1932.101.2.396

10.3171/jns.2000.92.5.0873

10.1212/WNL.51.3.786

10.1016/S0161-6420(94)31340-6

10.3171/jns.1998.88.5.0912

10.1213/00000539-199410000-00034

10.1212/WNL.43.3_Part_1.609

10.3171/jns.1998.88.2.0243

10.1212/WNL.42.8.1628

Schaltenbrand, 1940, Die akute Aliquorrhoe, Verh Dtsch Ges Inn Med, 52, 473

10.4065/72.5.400

10.3171/jns.1998.89.3.0483

10.1097/00003072-199803000-00003

10.1046/j.1526-4610.2000.00043.x

10.1093/milmed/155.2.64

10.1016/S0140-6736(96)91048-X

10.1212/WNL.45.10.1801

10.1212/WNL.50.6.1854

10.3171/jns.1996.84.4.0598

10.1212/WNL.42.3.481

El Gammal, 1998, Cerebrospinal fluidfistula: detection with MR cisternography, AJNR, 19, 627

Yousry, 2001, Cervical MR Imaging inPostural Headache: MR Signs and Pathophysiological Implications, AJNR, 22, 1239

10.1001/archneurpsyc.1943.02290150011001

Thông tin
Thông tin xuất bản

Canadian Journal of Neurological Sciences

Tập 29 Số 3

253-257

Thông tin tác giả