Diagnostic imaging and clinical features of intracranial hypotension – review of literature

Michali-Stolarska, Marta; Bladowska, Joanna; Stolarski, Mateusz; Sąsiadek, Marek

doi:10.5114/pjr.2018.72970

Cited by 7 publications

(11 citation statements)

References 9 publications

(14 reference statements)

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“…Eleven patients diagnosed to have obstructive hydrocephalus by conventional MRI were further investigated using PC MRI, which revealed the cause of hydrocephalus accurately; all of the patients were diagnosed as obstructive hydrocephalus by combination of conventional MRI, 3D DRIVE, and quantitative analysis through the aqueduct revealed irregular CSF flow curve, in agreement with Michali-Stolarska et al who found that the curve to be irregular in cases of obstruction [20].…”

Section: Discussionsupporting

confidence: 78%

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MRI CSF flowmetry in evaluation of different neurological diseases

Ahmad

Salama

Al-Haggar

2021

Egypt J Radiol Nucl Med

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Background Phase contrast MR imaging is a rapid and non-invasive technique which is sensitive in diagnosis and follow-up of different neurological diseases that cause CSF flow abnormality. MRI CSF flowmetry will be currently assessed in different neurological diseases that may cause CSF flow abnormalities. Results This study includes 39 patients with their ages ranging from 1 to 65 years; they were referred from the neurology department, with nine individuals of matched age and sex as a control group. Based on clinical history and conventional MRI, patients were subdivided into five subgroups; normal pressure hydrocephalus (NPH), hydrocephalus, idiopathic intracranial hypertension (IIH), brain atrophy (BA), and Chiari malformation type I (CM-I). All patients and control were subjected to MRI CSF flowmetry evaluation with stress on peak diastolic velocity (PDV), peak systolic velocity (PSV), stroke volume (SV), and maximum velocity (Vmax). PDV, PSV, and SV were found significantly higher in NPH, CM-I, and hydrocephalus compared to control (4.2, 4.96, and 83.23 for NPH; 3.95, 4.93, and 37.38 for CM-I; and 4.2, 5.6, and 125 in hydrocephalus versus 2.11, 2.73, and 75.33 in control, respectively; P = 0.0004, 0.0008, and 0.0009 for NPH; 0.03, 0.003, and 0.06 for CM-I; and 0.0005, 0.0002, and 0.0003, respectively). On the other hand, patients with BA showed significantly lower values (1.37, 1.66, and 1.53, respectively) compared to control (P = 0.001, 0.001, and 0.004, respectively). Conclusion MRI CSF flowmetry provides an easy, accurate, and non-invasive method for diagnosis of different neurological diseases that cause CSF flow abnormality. Moreover, this diagnostic modality could be helpful in selecting the therapeutic option.

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Section: Discussionsupporting

confidence: 78%

“…Hydrocephalus is classified into communicating and non-communicating (obstructive) and hence PC MRI can be used for such classification. Also, it can be used to determine the cause of obstruction in obstructive hydrocephalus if ordinary MRI sequences could not accurately detect it [20].…”

Section: Discussionmentioning

confidence: 99%

MRI CSF flowmetry in evaluation of different neurological diseases

Ahmad

Salama

Al-Haggar

2021

Egypt J Radiol Nucl Med

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“…Intracranial hypotension is caused by a CSF volume decrease (leak) due to dural weakness. The primary intracranial hypotension is called SIH, and the secondary types are due to over-draining CSF shunts, traumatic events (major injuries or brachial plexus injuries), true hypovolemic state and herniated discs (4,5). Contributing SIH factors include connective tissue disorders and trivial trauma (fall, sudden twist and stretch, sports activities, coughing, pulling, pushing, and lifting) (2, 6, 7).…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Intracranial Hypotension with a Reversible Splenial Lesion after Swimming

et al. 2020

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Spontaneous intracranial hypotension (SIH) is an important cause of headache mainly associated with spinal cerebrospinal fluid leakage. We herein report the case of a 51-year-old man who developed SIH after swimming. Brain magnetic resonance imaging (MRI) showed a transient high-intensity lesion in the splenium of the corpus callosum (SCC), in addition to bilateral subdural hematomas (SDH) and pseudo-subarachnoid hemorrhage on brain computed tomography. The splenial lesion disappeared and SDH improved after an epidural blood patch. This case emphasizes that transient SCC lesions could coexist with SIH and that SIH should be considered in the differential diagnosis of SCC lesions.

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“…When patients underwent brain MRI with gadolinium enhancement, the following 5 features were evaluated: (1) pachymeningeal enhancement; (2) subdural fluid collections; (3) engorgement of venous structures; (4) pituitary hyperemia; and (5) sagittal sagging (Fig. ) . If patients underwent non‐enhanced MRI, pachymeningeal enhancement was not evaluated.…”

Section: Methodsmentioning

confidence: 99%

Clinical Features of Patients With Spontaneous Intracranial Hypotension Complicated With Bilateral Subdural Fluid Collections

et al. 2019

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Background Subdural hygromas are often found bilaterally in spontaneous intracranial hypotension (SIH). They frequently progress to chronic subdural hematomas (CSDHs), and if the hematomas are formed, it is difficult to consider SIH as an underlying cause. Whether SIH is underlying or not among the patients presenting bilateral subdural fluid collections (hygromas or CSDHs) is clinically important because the treatment strategy should be different between them. Objectives We designed a retrospective case‐control study to figure out differential clinical features of the patients presenting bilateral symptomatic subdural fluid collections owing to SIH. Methods Sixty‐two patients with bilateral symptomatic subdural fluid collections were enrolled, and their data on general demographics, clinical courses, radiological findings, treatments, and outcomes were collected. The patients were divided into “SIH” and “Non‐SIH” groups, and a simple logistic regression analysis was performed to clarify the differences between the groups. The consequent receiver operating characteristics (ROC) curve analyses were performed with the significant predictors. Results Eight patients (13%) were diagnosed with SIH. Young age (odds ratio [OR] = 0.831, 95% confidence interval [CI]: 0.743‐0.929, P = .0012), no underlying disease (OR = 0.062, 95% CI: 0.007‐0.544, P = .0121), radiological features of brain sagging (OR = 10.36, 95% CI: 0.912‐93.411, P = .0017), pseudo‐subarachnoid hemorrhage (OR = 15.6, 95% CI: 2.088‐116.52, P = .0074), and small amount of fluid collections (OR = 0.719, 95% CI: 0.579‐0.893, P = .0029) were significantly associated with SIH group. ROC curve analyses were performed in parameters of age and amount of fluid collection and the cut‐off values for each parameter were ≤55 years old and ≤22.08 mm, respectively. Patients diagnosed with SIH underwent epidural blood patches and showed good results, except 1 patient who underwent burr‐hole trephinations. Conclusion Bilateral subdural fluid collections due to underlying SIH is associated with young age (≤55 years old), no underlying diseases, smaller amount of fluid collections (≤22.08 mm of depth), and radiological findings of brain sagging or pseudo‐subarachnoid hemorrhages.

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Diagnostic imaging and clinical features of intracranial hypotension – review of literature

Cited by 7 publications

References 9 publications

MRI CSF flowmetry in evaluation of different neurological diseases

MRI CSF flowmetry in evaluation of different neurological diseases

Spontaneous Intracranial Hypotension with a Reversible Splenial Lesion after Swimming

Clinical Features of Patients With Spontaneous Intracranial Hypotension Complicated With Bilateral Subdural Fluid Collections

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