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[Spontaneous intracranial hypotension].

E Franco1, A Gil-Peralta, E Salinas

  • 1Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, España.

Revista De Neurologia
|January 19, 2000
PubMed
Summary

Spontaneous intracranial hypotension, a condition causing postural headaches and diplopia, can be diagnosed through cerebrospinal fluid (CSF) analysis and neuroimaging. This syndrome often resolves with conservative treatment.

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Area of Science:

  • Neurology
  • Radiology

Background:

  • Spontaneous intracranial hypotension (SIH) is a condition characterized by cerebrospinal fluid (CSF) loss, leading to low intracranial pressure.
  • SIH can present with postural headaches, neck pain, and neurological deficits, often mimicking other conditions.

Observation:

  • A 38-year-old woman presented with postural interscapular pain, pulsating headaches, and diplopia, indicative of left sixth cranial nerve paresis.
  • Lumbar puncture revealed low opening pressure and slightly elevated CSF protein, while CT showed effaced sulci and small ventricles.
  • Cerebral MRI demonstrated diffuse meningeal hyper-intensity and absent basal cisterns; isotopic cisternography suggested hypotension without fistulas.

Findings:

  • Neuroimaging findings, including meningeal enhancement and effaced ventricles, are characteristic of SIH.

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  • Cerebrospinal fluid (CSF) analysis and advanced imaging like MRI and CT are crucial for diagnosing SIH.
  • Conservative management led to rapid symptom resolution, highlighting the condition's typically favorable prognosis.

    • Implications:

    • Misdiagnosis of SIH can lead to unnecessary invasive procedures due to its varied presentation.
    • Increased awareness of SIH's neuroimaging and CSF findings can improve diagnostic accuracy.
    • Prompt diagnosis and conservative treatment are key for managing SIH and achieving favorable patient outcomes.