Diagnosis and treatment evaluation in patients with spontaneous intracranial hypotension.
CSF hypovolaemia
CSF hypovolemia
CSF leak
CSF venous fistula
orthostatic headache
spontaneous intracranial hypotension
Journal
Frontiers in neurology
ISSN: 1664-2295
Titre abrégé: Front Neurol
Pays: Switzerland
ID NLM: 101546899
Informations de publication
Date de publication:
2023
2023
Historique:
received:
16
01
2023
accepted:
21
02
2023
entrez:
27
3
2023
pubmed:
28
3
2023
medline:
28
3
2023
Statut:
epublish
Résumé
Spontaneous intracranial hypotension is characterized by an orthostatic headache and audiovestibular symptoms alongside a myriad of other non-specific symptoms. It is caused by an unregulated loss of cerebrospinal fluid at the spinal level. Indirect features of CSF leaks are seen on brain imaging as signs of intracranial hypotension and/or CSF hypovolaemia as well as a low opening pressure on lumbar puncture. Direct evidence of CSF leaks can frequently, but not invariably, be observed on spinal imaging. The condition is frequently misdiagnosed due to its vague symptoms and a lack of awareness of the condition amongst the non-neurological specialities. There is also a distinct lack of consensus on which of the many investigative and treatment options available to use when managing suspected CSF leaks. The aim of this article is to review the current literature on spontaneous intracranial hypotension and its clinical presentation, preferred investigation modalities, and most efficacious treatment options. By doing so, we hope to provide a framework on how to approach a patient with suspected spontaneous intracranial hypotension and help minimize diagnostic and treatment delays in order to improve clinical outcomes.
Identifiants
pubmed: 36970531
doi: 10.3389/fneur.2023.1145949
pmc: PMC10036855
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
1145949Informations de copyright
Copyright © 2023 Mehta, Cheema, Davagnanam and Matharu.
Déclaration de conflit d'intérêts
MM is chair of the medical advisory board of the CSF Leak Association; has served on advisory boards for Allergan, Autonomic Technologies Inc, Eli Lilly, Novartis, Pfizer, Salvia, and TEVA, has received payment for educational presentations from Allergan, electroCore, Eli Lilly, Novartis and TEVA, has received grants from Abbott, Medtronic and electroCore, and has a patent on system and method for diagnosing and treating headaches (WO2018051103A1, issued). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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