1. Spontaneous Intracranial Hypotension: Correlation of Imaging Findings with Clinical Features
- Author
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Anja Windhagen, Elke Wiesemann, Friedrich Goetz, and Georg Berding
- Subjects
Adult ,Male ,Gadolinium ,Cerebrospinal fluid ,Cerebrospinal Fluid Pressure ,X ray computed ,medicine ,Humans ,Spontaneous Intracranial Hypotension ,Radionuclide imaging ,Radionuclide Imaging ,Intracranial Hypotension ,Aged ,medicine.diagnostic_test ,business.industry ,Brain ,Magnetic resonance imaging ,Middle Aged ,Magnetic Resonance Imaging ,Radiographic Image Enhancement ,Neurology ,Anesthesia ,Female ,Neurology (clinical) ,Cerebrospinal fluid pressure ,Intracranial Hypertension ,Tomography, X-Ray Computed ,business - Abstract
Background: Spontaneous intracranial hypotension (SIH) is increasingly recognized as a clinically variable and likely underdiagnosed syndrome caused by non-traumatic CSF leaks. The aim of this study was to correlate the findings of imaging studies – magnetic resonance imaging (MRI), radionuclide cisternography – with clinical features and CSF pressure in SIH in order to improve the diagnostic yield and management in patients with SIH. Methods: Clinical case study of 10 consecutive cases of SIH, MRI, radio-isotope cisternography. Results: 5 out of 10 patientshad unusual clinical symptoms of SIH(2 subdural haematomas, 1 gait ataxia, 1 tinnitus, 1 haemodialysis-associated headache). In 7 patients pachymeningeal gadolinium enhancement was detected in MRI accompanied by a reduced CSF opening pressure. In contrast, the 3 patients with normal MRI also had a normal CSF pressure. Radio-isotope cisternography was abnormal in all patients tested. There was no correlation between the severity of clinical symptoms and MRI or radionuclide cisternography findings. Conclusions: The spectrum of clinical symptoms and imaging findings in SIH is highly variable. There- fore the diagnosis of SIH is often delayed. Radio-isotope cisternography is an important additional diagnostic method to detect CSF leaks or pathological kinetics of radio-isotope movement particularly in cases with normal MRI findings.
- Published
- 2006
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