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 patients had 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. Copyright (c) 2006 S. Karger AG, Basel.
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 patients had 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. Copyright (c) 2006 S. Karger AG, Basel.
Authors: M C Garcia-Carreira; D Cánovas Vergé; J Branera; M Zauner; J Estela Herrero; E Tió; G Ribera Perpinyà Journal: Case Rep Neurol Med Date: 2014-11-27
Authors: Refik Pul; Özlem Yildiz; Franco Morbiducci; Thomas Skripuletz; Philipp Schwenkenbecher; Martin Stangel; Friedrich Götz; Georg Berding; Corinna Trebst; Frank Donnerstag Journal: Dis Markers Date: 2015-09-10 Impact factor: 3.434