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Intracranial Hypotension
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. Graff-Radford SB et al: High-pressure headaches, low-pressure syndromes, and CSF leaks: diagnosis and management. Headache. 54(2):394-401, 2014
                                                2. Tung H et al: Usefulness of phase-contrast magnetic resonance imaging for diagnosis and treatment evaluation in patients with SIH. Cephalalgia. 34(8):584-593, 2014
                                                3. Schievink WI et al: Diagnostic criteria for headache due to spontaneous intracranial hypotension: a perspective. Headache. 51(9):1442-4, 2011
                                                4. 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
                                                5. 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
                                                6. Forghani R et al: Diagnosis and temporal evolution of signs of intracranial hypotension on MRI of the brain. Neuroradiology. 50(12):1025-34, 2008
                                                7. Schievink WI et al: Connective tissue disorders with spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension: a prospective study. Neurosurgery. 54(1):65-70; discussion 70-1, 2004
                                                8. Schievink WI et al: False localizing sign of C1-2 cerebrospinal fluid leak in spontaneous intracranial hypotension. J Neurosurg. 100(4):639-44, 2004
                                                9. de Noronha RJ et al: Subdural haematoma: a potentially serious consequence of spontaneous intracranial hypotension. J Neurol Neurosurg Psychiatry. 74(6):752-5, 2003
                                                10. Koss SA et al: Angiographic features of spontaneous intracranial hypotension. AJNR Am J Neuroradiol. 24(4):704-6, 2003
                                                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. Graff-Radford SB et al: High-pressure headaches, low-pressure syndromes, and CSF leaks: diagnosis and management. Headache. 54(2):394-401, 2014
                                                                                              2. Tung H et al: Usefulness of phase-contrast magnetic resonance imaging for diagnosis and treatment evaluation in patients with SIH. Cephalalgia. 34(8):584-593, 2014
                                                                                              3. Schievink WI et al: Diagnostic criteria for headache due to spontaneous intracranial hypotension: a perspective. Headache. 51(9):1442-4, 2011
                                                                                              4. 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
                                                                                              5. 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
                                                                                              6. Forghani R et al: Diagnosis and temporal evolution of signs of intracranial hypotension on MRI of the brain. Neuroradiology. 50(12):1025-34, 2008
                                                                                              7. Schievink WI et al: Connective tissue disorders with spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension: a prospective study. Neurosurgery. 54(1):65-70; discussion 70-1, 2004
                                                                                              8. Schievink WI et al: False localizing sign of C1-2 cerebrospinal fluid leak in spontaneous intracranial hypotension. J Neurosurg. 100(4):639-44, 2004
                                                                                              9. de Noronha RJ et al: Subdural haematoma: a potentially serious consequence of spontaneous intracranial hypotension. J Neurol Neurosurg Psychiatry. 74(6):752-5, 2003
                                                                                              10. Koss SA et al: Angiographic features of spontaneous intracranial hypotension. AJNR Am J Neuroradiol. 24(4):704-6, 2003