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Spontaneous intracranial hypotension


Authors: H. Zítek 1;  M. Stratilová 1;  T. Radovnický 1;  A. Sejkorová 1;  L. Hofmann Klzo 2,3;  M. Sameš 1
Authors place of work: Neurochirurgická klinika FZS UJEP, a KZ, a. s. – Masarykovy nemocnice, v Ústí nad Labem, o. z. 1;  Radiologická klinika FN Hradec, Králové 2;  Radiodiagnostické oddělení KZ, a. s. –, Nemocnice Teplice, o. z. 3
Published in the journal: Cesk Slov Neurol N 2022; 85(1): 18-23
Category: Přehledný referát
doi: https://doi.org/10.48095/cccsnn202218

Summary

Spontaneous intracranial hypotension (SIH) is a disease in which headache is the main symptom. Recently, it has become an important part of the broad differential diagnosis of causes of headache. Advances in understanding of pathophysiology, indication of proper imaging modalities, and expansion of microsurgical techniques contributed to increased recognition of the disease. Young patients in productive age commonly suffer from SIH, and it might negatively influence both their social and professional life. Therefore, it is of great importance to recognize the symptoms of the disease and treat it properly. The aim of our article is to provide a review of the pathogenesis, current recommendations for the diagnosis and therapy of SIH. A report of a typical case should support our effort.

Keywords:

spontaneous intracranial hypotension – orthostatic headache – cerebrospinal fluid leakage – epidural blood plug


Zdroje

1. Schaltenbrand G. Neuere Anschauungen zur Pathophysiologie der Liquorzirkulation. Zentralbl Neurochir 1938; 3: 290–300.

2. Schievink WI. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. Jama 2006; 295(19): 2286–2296. doi: 10.1001/jama.295.19.2286.

3. Beck J, Häni L, Ulrich CT et al. Diagnostic challenges and therapeutic possibilities in spontaneous intracranial hypotension. Clin Transl Neurosci 2018; 2(2): 2514183X1878737. doi: 10.1177/2514183X18787371.

4. Headache classification committee of the International Headache Society (IHS) the international classification of headache disorders, 3rd edition. Cephalalgia 2018; 38(1): 1–211. doi: 10.1177/0333102417738202.

5. Mokri B. Spontaneous low pressure, low CSF volume headaches: spontaneous CSF leaks. Headache 2013; 53(7): 1034–1053. doi: 10.1111/head.12149.

6. Paldino M, Mogilner AY, Tenner MS. Intracranial hypotension syndrome: a comprehensive review. Neurosurg Focus 2003; 15(6): ECP2.

7. Ducros A, Biousse V. Headache arising from idiopathic changes in CSF pressure. Lancet Neurol 2015; 14(6): 655–668. doi: 10.1016/S1474-4422(15)00015-0.

8. Beck J, Ulrich CT, Fung C et al. Diskogenic microspurs as a major cause of intractable spontaneous intracranial hypotension. Neurology 2016; 87(12): 1220–1226. doi: 10.1212/WNL.0000000000003122.

9. Kranz PG, Tanpitukpongse TP, Choudhury KR et al. How common is normal cerebrospinal fluid pressure in spontaneous intracranial hypotension? Cephalalgia 2016; 36(13): 1209–1217. doi: 10.1177/0333102415623071.

10. He FF, Li L, Liu MJ et al. Targeted epidural blood patch treatment for refractory spontaneous intracranial hypotension in China. J Neurol Surg B Skull Base 2018; 79(3): 217–223. doi: 10.1055/s-0037-1606312.

11. Mokri B. Spontaneous intracranial hypotension. Continuum (Minneap Minn) 2015; 21(4 Headache): 1086–1108. doi: 10.1212/CON.0000000000000193.

12. Kranz PG, Gray L, Malinzak MD et al. Spontaneous intracranial hypotension: pathogenesis, diagnosis, and treatment. Neuroimaging Clin N Am 2019; 29(4): 581–594. doi: 10.1016/j.nic.2019.07.006.

13. Monro A. Observations on structure and functions of the nervous system. Lond Med J 1783; 4(2): 113–135.

14. Watanabe A, Horikoshi T, Uchida M et al. Diagnostic value of spinal MR imaging in spontaneous intracranial hypotension syndrome. AJNR Am J Neuroradiol 2009; 30(1): 147–151. doi: 10.3174/ajnr.A1277.

15. Farb RI, Forghani R, Lee SK et al., The venous distension sign: a diagnostic sign of intracranial hypotension at MR imaging of the brain. AJNR Am J Neuroradiol 2007; 28(8): 1489–1493. doi: 10.3174/ajnr.A0621.

16. Mokri B. Spontaneous cerebrospinal fluid leaks: from intracranial hypotension to cerebrospinal fluid hypovolemia – evolution of a concept. Mayo Clin Proc 1999; 74(11): 1113–1123. doi: 10.4065/74.11.1113.

17. Takahashi K, Mima T, Akiba Y. Chronic subdural hematoma associated with spontaneous intracranial hypotension: therapeutic strategies and outcomes of 55 cases. Neurol Med Chir (Tokyo) 2016; 56(2): 69–76. doi: 10.2176/nmc.oa.2015-0032.

18. Rabin BM, Roychowdhury S, Meyer JR et al. Spontaneous intracranial hypotension: spinal MR findings. AJNR Am J Neuroradiol 1998; 19(6): 1034–1039.

19. Tsai PH, Fuh JL, Lirng JF et al. Heavily T2-weighted MR myelography in patients with spontaneous intracranial hypotension: a case-control study. Cephalalgia 2007; 27(8): 929–934. doi: 10.1111/j.1468-2982.2007.01376.x.

20. Chiapparini L, Farina L, D´Incerti L et al. Spinal radiological findings in nine patients with spontaneous intracranial hypotension. Neuroradiology 2002; 44(2): 143–150. doi: 10.1007/s002340100685.

21. Wendl CM, Schambach F, Zimmer C et al. CT myelography for the planning and guidance of targeted epidural blood patches in patients with persistent spinal CSF leakage. AJNR Am J Neuroradiol 2012; 33(3): 541–544. doi: 10.3174/ajnr.A2808.

22. Kranz PG, Luetmer PH, Diehn FE et al. Myelographic techniques for the detection of spinal CSF leaks in spontaneous intracranial hypotension. AJR Am J Roentgenol 2016; 206(1): 8–19. doi: 10.2214/AJR.15.14884.

23. Urbach H. Intracranial hypotension: clinical presentation, imaging findings, and imaging-guided therapy. Curr Opin Neurol 2014; 27(4): 414–424. doi: 10.1097/WCO.0000000000000105.

24. Dobrocky T, Mosimann PJ, Zibold F et al. Cryptogenic cerebrospinal fluid leaks in spontaneous intracranial hypotension: role of dynamic CT myelography. Radiology 2018; 289(3): 766–772. doi: 10.1148/radiol.2018180732.

25. Urbach H, Fung C, Dovi-Akue P et al. Spontaneous intracranial hypotension. Dtsch Arztebl Int 2020; 117(27–28): 480–487. doi: 10.3238/arztebl.2020.0480.

26. Farb RI, Nicholson PJ, Peng PW et al. Spontaneous intracranial hypotension: a systematic imaging approach for CSF leak localization and management based on MRI and digital subtraction myelography. AJNR Am J Neuroradiol 2019; 40(4): 745–753. doi: 10.3174/ajnr.A6016.

27. Hoxworth JM, Trentman TL, Kotsenas AL et al. The role of digital subtraction myelography in the diagnosis and localization of spontaneous spinal CSF leaks. AJR Am J Roentgenol 2012; 199(3): 649–653. doi: 10.2214/AJR.11.8238.

28. Amrhein TJ, Kranz PG. Spontaneous intracranial hypotension: imaging in diagnosis and treatment. Radiol Clin North Am 2019; 57(2): 439–451. doi: 10.1016/j.rcl.2018.10.004.

29. Ahn C, Lee E, Lee JW et al. Two-site blind epidural blood patch versus targeted epidural blood patch in spontaneous intracranial hypotension. J Clin Neurosci 2019; 62: 147–154. doi: 10.1016/j.jocn.2018.11.039.

30. Cho KI, Moon HS, Jeon HJ et al. Spontaneous intracranial hypotension: efficacy of radiologic targeting vs blind blood patch. Neurology 2011; 76(13): 1139–1144. doi: 10.1212/WNL.0b013e318212ab43.

31. Beck J, Raabe A, Schievink WI et al. Posterior approach and spinal cord release for 360 degrees repair of dural defects in spontaneous intracranial hypotension. Neurosurgery 2019; 84(6): E345–E351. doi: 10.1093/neuros/nyy312.

32. Cohen-Gadol AA, Mokri B, Piepgras DG et al. Surgical anatomy of dural defects in spontaneous spinal cerebrospinal fluid leaks. Neurosurgery 2006; 58 (4 Suppl 2): 238–245. doi: 10.1227/01.NEU.0000204712.16099.FB.

33. Schievink WI, Morreale VM, Atkinson JL et al. Surgical treatment of spontaneous spinal cerebrospinal fluid leaks. J Neurosurg 1998; 88(2): 243–246. doi: 10.3171/jns.1998.88.2.0243.

34. Schievink WI, Moser FG, Maya MM et al. Digital subtraction myelography for the identification of spontaneous spinal CSF-venous fistulas. J Neurosurg Spine 2016; 24(6): 960–964. doi: 10.3171/2015.10.SPINE15855.

35. Brinjikji W, Savastano LE, Atkinson JLD et al. A novel endovascular therapy for CSF hypotension secondary to CSF-venous fistulas. AJNR Am J Neuroradiol 2021; 42(5): 882–887. doi: 10.3174/ajnr.A7014.

36. Davidson B, Nassiri F, Mansouri A et al. Spontaneous intracranial hypotension: a review and introduction of an algorithm for management. World Neurosurg 2017; 101: 343–349. doi: 10.1016/j.wneu.2017.01.123.

Štítky
Dětská neurologie Neurochirurgie Neurologie
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Česká a slovenská neurologie a neurochirurgie

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