Unusual neuroimaging findings in spontaneous intracranial hypotension.
CSF leak
CSF venous fistula
Spontaneous intracranial hypotension
Journal
Neuroradiology
ISSN: 1432-1920
Titre abrégé: Neuroradiology
Pays: Germany
ID NLM: 1302751
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
received:
11
01
2023
accepted:
25
02
2023
medline:
18
4
2023
pubmed:
7
3
2023
entrez:
6
3
2023
Statut:
ppublish
Résumé
The most common neuroimaging manifestations of patients suffering from spontaneous intracranial hypotension (SIH) include subdural fluid collections, enhancement of the pachymeninges, engorgement of venous structures, pituitary hyperemia, sagging of the brainstem, and cerebellar hemosiderosis. However, infrequently patients may present with separate neuroradiological findings which could be easily mistaken for other pathology. We describe patients who presented with unique neuroimaging findings who were eventually found to have a spinal CSF leak or venous fistula. Relevant clinical history and neuroradiology findings are presented, and a relevant review of the literature is provided. We present six patients with a proven CSF leak or fistula who presented with dural venous sinus thrombosis, compressive ischemic injury, spinal hemosiderosis, subarachnoid hemorrhage, pial vascular engorgement, calvarial hyperostosis, and spinal dural calcifications. Radiologists should be familiar with atypical neuroimaging manifestations of SIH in order to avoid misdiagnosis and guide the clinical trajectory of the patient towards accurate diagnosis and eventual cure.
Identifiants
pubmed: 36879063
doi: 10.1007/s00234-023-03136-7
pii: 10.1007/s00234-023-03136-7
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
875-882Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Schievink WI (2021) Spontaneous Intracranial hypotension. N Engl J Med 385:2173–2178
doi: 10.1056/NEJMra2101561
pubmed: 34874632
Michali-Stolarska M, Bladowska J, Stolarski M, Sąsiadek MJ (2017) Diagnostic imaging and clinical features of intracranial hypotension - review of literature. Pol J Radiol 82:842–849
doi: 10.12659/PJR.904433
pubmed: 29657653
pmcid: 5894032
Bladowska J, Warren DJ, Muto M, Romanowski CAJ (2019) CSF Hypotension and CSF Leaks. In: Barkhof F, Jager R, Thurnher M, Rovira Cañellas A (eds) Clinical Neuroradiology: The ESNR Textbook. Springer International Publishing, pp 1–22
Choi H, Lee MJ, Choi HA, Cha J, Chung C-S (2018) Intracranial structural alteration predicts treatment outcome in patients with spontaneous intracranial hypotension. Cephalalgia 38:323–331
doi: 10.1177/0333102417690106
pubmed: 28110544
Mokri B (2001) The Monro-Kellie hypothesis: applications in CSF volume depletion. Neurology 56:1746–1748
doi: 10.1212/WNL.56.12.1746
pubmed: 11425944
Dobrocky T et al (2019) Assessing spinal cerebrospinal fluid leaks in spontaneous intracranial hypotension with a scoring system based on brain magnetic resonance imaging Findings. JAMA Neurol 76:580–587
doi: 10.1001/jamaneurol.2018.4921
pubmed: 30776059
pmcid: 6515981
Schievink WI, Maya M, Moser F, Nuño M (2021) Long-term risks of persistent ventral spinal CSF leaks in sih: superficial siderosis and bibrachial amyotrophy. Neurology 97:e1964–e1970
doi: 10.1212/WNL.0000000000012786
pubmed: 34504024
Schievink, W. I. et al. Infratentorial Superficial siderosis and spontaneous intracranial hypotension. Ann Neurol 93(1):64-75 (2022) https://doi.org/10.1002/ana.26521 .
doi: 10.1002/ana.26521
pubmed: 36200700
Houk JL, Amrhein TJ, Gray L, Malinzak MD, Kranz PG (2021) Differentiation of Chiari malformation type 1 and spontaneous intracranial hypotension using objective measurements of midbrain sagging. J Neurosurg 29:1–8. https://doi.org/10.3171/2021.6.JNS211010
doi: 10.3171/2021.6.JNS211010
Kranz PG, Gray L, Amrhein TJ (2018) Spontaneous intracranial hypotension: 10 myths and misperceptions. Headache 58:948–959
doi: 10.1111/head.13328
pubmed: 29797515
Yoon K-W, Cho M-K, Kim YJ, Lee S-K (2011) Sinus thrombosis in a patient with intracranial hypotension: a suggested hypothesis of venous stasis. a case report. Interv Neuroradiol 17:248–251
doi: 10.1177/159101991101700218
pubmed: 21696667
pmcid: 3287279
Mokri B (2013) Spontaneous low pressure, low CSF volume headaches: spontaneous CSF leaks. Headache 53:1034–1053
doi: 10.1111/head.12149
pubmed: 23808630
Berroir S, Grabli D, Héran F, Bakouche P, Bousser M-G (2004) Cerebral sinus venous thrombosis in two patients with spontaneous intracranial hypotension. Cerebrovasc Dis 17:9–12
doi: 10.1159/000073892
pubmed: 14530632
Wang Y-F, Fuh J-L, Lirng J-F, Chang F-C, Wang S-J (2007) Spontaneous intracranial hypotension with isolated cortical vein thrombosis and subarachnoid haemorrhage. Cephalalgia 27:1413–1417
doi: 10.1111/j.1468-2982.2007.01437.x
pubmed: 17888012
Mamlouk MD, Shen PY, Sedrak MF (2022) Spontaneous Intracranial hypotension in the critical patient. J Intensive Care Med 37:618–624
doi: 10.1177/08850666211024886
pubmed: 34184582
Binder DK, Dillon WP, Fishman RA, Schmidt MH (2002) Intrathecal saline infusion in the treatment of obtundation associated with spontaneous intracranial hypotension: technical case report. Neurosurgery 51:830–836; discussion 836–7
doi: 10.1097/00006123-200209000-00045
pubmed: 12188967
Wolf K, Luetzen N, Mast H, Kremers N, Reisert M, Beltrán S, Fung C, Beck J, Urbach H (2023) CSF flow and spinal cord motion in patients with spontaneous intracranial hypotension: a phase contrast MRI study. Neurology 100(7):e651–e660. https://doi.org/10.1212/WNL.0000000000201527
doi: 10.1212/WNL.0000000000201527
pubmed: 36357188
pmcid: 9969913
Johnson DR et al (2021) Diffuse calvarial hyperostosis in patients with spontaneous intracranial hypotension. World Neurosurg 146:e848–e853
doi: 10.1016/j.wneu.2020.11.066
pubmed: 33220476
Babcock JC et al (2022) Diffuse calvarial hyperostosis and spontaneous intracranial hypotension: a case-control study. AJNR Am J Neuroradiol 43:978–983
doi: 10.3174/ajnr.A7557
pubmed: 35772803
Di Preta JA, Powers JM, Hicks DG (1994) Hyperostosis cranii ex vacuo: a rare complication of shunting for hydrocephalus. Hum Pathol 25:545–547
doi: 10.1016/0046-8177(94)90130-9
pubmed: 8200652