Benjamin Davidson1, Farshad Nassiri2, Alireza Mansouri2, Jetan H Badhiwala2, Christopher D Witiw2, Mohammed F Shamji2, Philip W Peng3, Richard I Farb4, Mark Bernstein2. 1. Department of Surgery, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada. Electronic address: benjaminandrewdavidson@gmail.com. 2. Department of Surgery, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada. 3. Department of Surgery, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada; Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada. 4. Department of Surgery, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
Abstract
BACKGROUND: Spontaneous intracranial hypotension (SIH) is a condition of low cerebrospinal fluid volume and pressure caused by a leak of cerebrospinal fluid through a dural defect. Diagnosis and management can be difficult, often requiring coordination between multiple disciplines for myelography, blood patching, and possible surgical repair. Patients should be monitored closely, because they can deteriorate into a coma or even death. There are no widely accepted guidelines for the management of SIH. METHODS AND CONCLUSIONS: We review the existing SIH literature, illustrate management challenges via a case review, and propose an algorithm developed by neurosurgeons, radiologists, and anesthesiologists intended to simplify and streamline the management of SIH.
BACKGROUND: Spontaneous intracranial hypotension (SIH) is a condition of low cerebrospinal fluid volume and pressure caused by a leak of cerebrospinal fluid through a dural defect. Diagnosis and management can be difficult, often requiring coordination between multiple disciplines for myelography, blood patching, and possible surgical repair. Patients should be monitored closely, because they can deteriorate into a coma or even death. There are no widely accepted guidelines for the management of SIH. METHODS AND CONCLUSIONS: We review the existing SIH literature, illustrate management challenges via a case review, and propose an algorithm developed by neurosurgeons, radiologists, and anesthesiologists intended to simplify and streamline the management of SIH.
Authors: Carlos Perez-Vega; Pilar Robles-Lomelin; Isabel Robles-Lomelin; Alexandra Diaz-Alba; Victor Garcia Navarro Journal: Surg Neurol Int Date: 2020-10-02
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