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[Spontaneous intracranial hypotension syndrome]
S Ben Amor1, P Maeder, F Gudinchet
1Service de Neurochirurgie, Institut National de Neurologie, Tunis, Tunisie.
Revue Neurologique
|October 1, 1996
Summary
Spontaneous intracranial hypotension, a rare condition, presents with severe headaches and low cerebrospinal fluid pressure. Characteristic MRI findings include meningeal enhancement and thickening, suggesting chronic subdural bleeding.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Spontaneous intracranial hypotension (SIH) is a rare neurological disorder.
- Characterized by low cerebrospinal fluid (CSF) pressure without a clear cause.
- First described by German neurosurgeon Schaltenbrand.
Observation:
- Four patients (2 male, 2 female, mean age 55) presented with SIH.
- All experienced intense postural headaches and low CSF pressure.
- No history of recent lumbar puncture, surgery, or trauma.
Findings:
- Consistent MRI findings included intense meningeal enhancement and thickening.
- Thin, slit-like ventricles and cerebellar tonsil descent were observed.
- Meningeal biopsy showed fibrosis and signs of old hemorrhage.
Implications:
- Findings suggest chronic subdural bleeding due to CSF hypotension.
- SIH has a generally benign course with rarely identified underlying causes.
- Further investigation for CSF leaks may be considered, though conservative management is often effective.