Wouter I Schievink1. 1. Department of Neurosurgery, Cedars-Sinai Medical Center, 8631 West Third Street, Suite 800E, Los Angeles, CA 90048, USA.
Abstract
BACKGROUND AND OBJECTIVE: Spontaneous intracranial hypotension has become a well-described cause of headache particularly among young and middle-aged individuals. Treatment of the underlying spinal cerebrospinal fluid (CSF) leak is effective in relieving symptoms in the vast majority of patients but symptoms may become refractory. The author describes a novel surgical technique to treat intractable spontaneous intracranial hypotension. METHODS: A lumbar laminectomy is performed, a strip of dura is resected, and the dural defect is closed. The resulting decrease in lumbar CSF volume is believed to increase intracranial CSF volume and pressure. RESULTS: The technique was utilized in a patient who suffered with intractable positional headaches because of a spinal CSF leak for 6 years in spite of numerous surgical and nonsurgical therapies. Significant improvement of symptoms was sustained during a 1-year period of follow-up. CONCLUSION: Dural reduction surgery may be considered in carefully selected patients with intracranial hypotension.
BACKGROUND AND OBJECTIVE: Spontaneous intracranial hypotension has become a well-described cause of headache particularly among young and middle-aged individuals. Treatment of the underlying spinal cerebrospinal fluid (CSF) leak is effective in relieving symptoms in the vast majority of patients but symptoms may become refractory. The author describes a novel surgical technique to treat intractable spontaneous intracranial hypotension. METHODS: A lumbar laminectomy is performed, a strip of dura is resected, and the dural defect is closed. The resulting decrease in lumbar CSF volume is believed to increase intracranial CSF volume and pressure. RESULTS: The technique was utilized in a patient who suffered with intractable positional headaches because of a spinal CSF leak for 6 years in spite of numerous surgical and nonsurgical therapies. Significant improvement of symptoms was sustained during a 1-year period of follow-up. CONCLUSION: Dural reduction surgery may be considered in carefully selected patients with intracranial hypotension.
Authors: K M Bond; J C Benson; J K Cutsforth-Gregory; D K Kim; F E Diehn; C M Carr Journal: AJNR Am J Neuroradiol Date: 2020-07-09 Impact factor: 3.825
Authors: Saba Shahab; Mohamed A R Soliman; Abdullah F Alkhamees; Sydney Eaton; Elise Quint; Jacob Im; Avalon O'Connor; Erika Haberfellner; Abdalla Shamisa Journal: Surg Neurol Int Date: 2020-12-04