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Intracranial Hypotension
Kevin R. Moore, MD; Anne G. Osborn, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Intracranial hypotension (IH)
            • Definitions

              • Headache caused by ↓ intracranial CSF pressure

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Angiographic Findings

                      • Nonvascular Interventions

                        • Nuclear Medicine Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Amrhein TJ et al: Spontaneous intracranial hypotension: imaging in diagnosis and treatment. Radiol Clin North Am. 57(2):439-51, 2019
                                                2. Kim SC et al: MRI findings of spontaneous intracranial hypotension: usefulness of straight sinus distention. AJR Am J Roentgenol. 1-7, 2019
                                                3. Upadhyaya P et al: A review of spontaneous intracranial hypotension. Curr Neurol Neurosci Rep. 19(5):22, 2019
                                                4. Dillon WP: Challenges in the diagnosis and treatment of spontaneous intracranial hypotension. Radiology. 289(3):773-4, 2018
                                                5. Lee JY et al: Clinical effect of the proximity of epidural blood patch injection to the leakage site in spontaneous intracranial hypotension. Br J Neurosurg. 32(6):671-3, 2018
                                                6. Wu JW et al: Correlations among brain and spinal MRI findings in spontaneous intracranial hypotension. Cephalalgia. 38(14):1998-2005, 2018
                                                7. Nesbitt C et al: Lumbar blood patching for proximal CSF leaks: where does the blood go? BMJ Case Rep. 2015, 2015
                                                8. Xia P et al: Risk factors for subdural haematoma in patients with spontaneous intracranial hypotension. PLoS One. 10(4):e0123616, 2015
                                                9. Graff-Radford SB et al: High-pressure headaches, low-pressure syndromes, and CSF leaks: diagnosis and management. Headache. 54(2):394-401, 2014
                                                10. Scott S et al: Low pressure headaches caused by spontaneous intracranial hypotension. BMJ. 349:g6219, 2014
                                                11. Tung H et al: Usefulness of phase-contrast magnetic resonance imaging for diagnosis and treatment evaluation in patients with SIH. Cephalalgia. 34(8):584-93, 2014
                                                12. Schievink WI et al: Diagnostic criteria for headache due to spontaneous intracranial hypotension: a perspective. Headache. 51(9):1442-4, 2011
                                                13. Shankar JJ et al: The venous hinge--an objective sign for the diagnosis and follow-up of treatment in patients with intracranial hypotension syndrome. Neuroradiology. 51(7):453-6, 2009
                                                14. Su CS et al: Clinical features, neuroimaging and treatment of spontaneous intracranial hypotension and magnetic resonance imaging evidence of blind epidural blood patch. Eur Neurol. 61(5):301-7, 2009
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Intracranial hypotension (IH)
                                                          • Definitions

                                                            • Headache caused by ↓ intracranial CSF pressure

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Angiographic Findings

                                                                    • Nonvascular Interventions

                                                                      • Nuclear Medicine Findings

                                                                        • Imaging Recommendations

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Amrhein TJ et al: Spontaneous intracranial hypotension: imaging in diagnosis and treatment. Radiol Clin North Am. 57(2):439-51, 2019
                                                                                              2. Kim SC et al: MRI findings of spontaneous intracranial hypotension: usefulness of straight sinus distention. AJR Am J Roentgenol. 1-7, 2019
                                                                                              3. Upadhyaya P et al: A review of spontaneous intracranial hypotension. Curr Neurol Neurosci Rep. 19(5):22, 2019
                                                                                              4. Dillon WP: Challenges in the diagnosis and treatment of spontaneous intracranial hypotension. Radiology. 289(3):773-4, 2018
                                                                                              5. Lee JY et al: Clinical effect of the proximity of epidural blood patch injection to the leakage site in spontaneous intracranial hypotension. Br J Neurosurg. 32(6):671-3, 2018
                                                                                              6. Wu JW et al: Correlations among brain and spinal MRI findings in spontaneous intracranial hypotension. Cephalalgia. 38(14):1998-2005, 2018
                                                                                              7. Nesbitt C et al: Lumbar blood patching for proximal CSF leaks: where does the blood go? BMJ Case Rep. 2015, 2015
                                                                                              8. Xia P et al: Risk factors for subdural haematoma in patients with spontaneous intracranial hypotension. PLoS One. 10(4):e0123616, 2015
                                                                                              9. Graff-Radford SB et al: High-pressure headaches, low-pressure syndromes, and CSF leaks: diagnosis and management. Headache. 54(2):394-401, 2014
                                                                                              10. Scott S et al: Low pressure headaches caused by spontaneous intracranial hypotension. BMJ. 349:g6219, 2014
                                                                                              11. Tung H et al: Usefulness of phase-contrast magnetic resonance imaging for diagnosis and treatment evaluation in patients with SIH. Cephalalgia. 34(8):584-93, 2014
                                                                                              12. Schievink WI et al: Diagnostic criteria for headache due to spontaneous intracranial hypotension: a perspective. Headache. 51(9):1442-4, 2011
                                                                                              13. Shankar JJ et al: The venous hinge--an objective sign for the diagnosis and follow-up of treatment in patients with intracranial hypotension syndrome. Neuroradiology. 51(7):453-6, 2009
                                                                                              14. Su CS et al: Clinical features, neuroimaging and treatment of spontaneous intracranial hypotension and magnetic resonance imaging evidence of blind epidural blood patch. Eur Neurol. 61(5):301-7, 2009