Direct connection between spinal subarachnoid space and paraspinal vein that permits unregulated loss of CSF
Slow leak so usually no epidural fluid present
IMAGING
General Features
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Chan SM et al: Intracranial hypotension and cerebrospinal fluid leak. Neuroimaging Clin N Am. 29(2):213-26, 2019
Dobrocky T et al: Assessing spinal cerebrospinal fluid leaks in spontaneous intracranial hypotension with a scoring system based on brain magnetic resonance imaging findings. JAMA Neurol. 76(5):580-7, 2019
Dobrocky T et al: Cryptogenic cerebrospinal fluid leaks in spontaneous intracranial hypotension: role of dynamic CT myelography. Radiology. 289(3):766-72, 2018
Kranz PG et al: CSF venous fistulas in spontaneous intracranial hypotension: imaging characteristics on dynamic and CT myelography. AJR Am J Roentgenol. 209(6):1360-6, 2017
Kranz PG et al: Myelographic techniques for the detection of spinal CSF leaks in spontaneous intracranial hypotension. AJR Am J Roentgenol. 206(1):8-19, 2016
Schievink WI et al: A classification system of spontaneous spinal CSF leaks. Neurology. 87(7):673-9, 2016
Schievink WI et al: CSF-venous fistula in spontaneous intracranial hypotension. Neurology. 83(5):472-3, 2014
Akbar JJ et al: The role of MR myelography with intrathecal gadolinium in localization of spinal CSF leaks in patients with spontaneous intracranial hypotension. AJNR Am J Neuroradiol. 33(3):535-40, 2012
Schievink WI et al: False localizing sign of C1-2 cerebrospinal fluid leak in spontaneous intracranial hypotension. J Neurosurg 100:639-44, 2004
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Spontaneous intracranial hypotension (SIH)
Definitions
Direct connection between spinal subarachnoid space and paraspinal vein that permits unregulated loss of CSF
Slow leak so usually no epidural fluid present
IMAGING
General Features
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Chan SM et al: Intracranial hypotension and cerebrospinal fluid leak. Neuroimaging Clin N Am. 29(2):213-26, 2019
Dobrocky T et al: Assessing spinal cerebrospinal fluid leaks in spontaneous intracranial hypotension with a scoring system based on brain magnetic resonance imaging findings. JAMA Neurol. 76(5):580-7, 2019
Dobrocky T et al: Cryptogenic cerebrospinal fluid leaks in spontaneous intracranial hypotension: role of dynamic CT myelography. Radiology. 289(3):766-72, 2018
Kranz PG et al: CSF venous fistulas in spontaneous intracranial hypotension: imaging characteristics on dynamic and CT myelography. AJR Am J Roentgenol. 209(6):1360-6, 2017
Kranz PG et al: Myelographic techniques for the detection of spinal CSF leaks in spontaneous intracranial hypotension. AJR Am J Roentgenol. 206(1):8-19, 2016
Schievink WI et al: A classification system of spontaneous spinal CSF leaks. Neurology. 87(7):673-9, 2016
Schievink WI et al: CSF-venous fistula in spontaneous intracranial hypotension. Neurology. 83(5):472-3, 2014
Akbar JJ et al: The role of MR myelography with intrathecal gadolinium in localization of spinal CSF leaks in patients with spontaneous intracranial hypotension. AJNR Am J Neuroradiol. 33(3):535-40, 2012
Schievink WI et al: False localizing sign of C1-2 cerebrospinal fluid leak in spontaneous intracranial hypotension. J Neurosurg 100:639-44, 2004
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