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Spontaneous intracranial hypotension: two steroid-responsive cases.

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  • 1Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy.

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|January 11, 2019
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Summary

Spontaneous intracranial hypotension (SIH) presents with orthostatic headaches and characteristic MRI findings. Conservative treatment, including rest and steroids, often provides lasting relief for SIH.

Keywords:
cerebrospinal fluid (CSF) pressuremyelopathyspontaneous intracranial hypotension (SIH)

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Area of Science:

  • Neurology
  • Radiology
  • Neurosurgery

Background:

  • Spontaneous intracranial hypotension (SIH) is a condition characterized by low cerebrospinal fluid pressure.
  • Orthostatic headache and diffuse pachymeningeal enhancement on MRI are key diagnostic features.

Observation:

  • Two cases of SIH with typical clinical and imaging findings are presented.
  • MRI revealed diffuse, intense pachymeningeal enhancement, venous distension, and epidural vein engorgement in both patients.

Findings:

  • The orthostatic nature of the headache is the most suggestive clinical symptom of SIH.
  • Contrast-enhanced MRI provides definitive diagnostic imaging findings for SIH.

Implications:

  • Conservative management, including bed rest and oral steroid therapy, can lead to complete and long-lasting symptomatic resolution.
  • Early diagnosis through clinical suspicion and MRI is crucial for effective SIH treatment.