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Spontaneous CSF leaks: low CSF volume syndromes
1Department of Neurology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Neurologic Clinics
|April 8, 2014
Summary
Spontaneous intracranial hypotension typically stems from cerebrospinal fluid (CSF) leaks, causing headaches and distinct imaging findings. However, symptoms, diagnostic results, and treatment responses show significant variability.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Spontaneous intracranial hypotension (SIH) is primarily caused by cerebrospinal fluid (CSF) leaks.
- These leaks commonly originate from the spinal level, with skull base origins being rare.
- The classic presentation includes orthostatic headaches, diffuse pachymeningeal enhancement on imaging, and low CSF opening pressure.
Purpose of the Study:
- To summarize the key aspects of spontaneous intracranial hypotension.
- To highlight the typical diagnostic triad and acknowledge its variability.
- To underscore the diverse clinical spectrum of SIH.
Main Methods:
- Review of existing literature on spontaneous intracranial hypotension.
- Analysis of characteristic clinical, imaging, and cerebrospinal fluid findings.
- Discussion of treatment responses and patient outcomes.
Main Results:
- Spontaneous intracranial hypotension is predominantly linked to spinal CSF leaks.
- The hallmark triad of orthostatic headaches, pachymeningeal enhancement, and low CSF pressure is frequently observed.
- Significant variability exists in headache characteristics, imaging features, CSF parameters, and treatment outcomes.
Conclusions:
- Spontaneous intracranial hypotension is a complex condition with a wide range of presentations.
- While a classic triad exists, clinicians must consider variations in SIH manifestations.
- Understanding this variability is crucial for accurate diagnosis and effective management.
Keywords:
Acquired Chiari malformationCSF hypovolemiaDiffuse patchy meningeal enhancementEpidural blood patchOrthostatic headachesRadioisotope cisternographySpontaneous CSF leakSpontaneous intracranial hypotension (SIH)More Related Videos
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