Diagnostic Imaging and Clinical Features of Intracranial Hypotension – Review of Literature

Abstract

SummaryIntracranial hypotension (IH) is an uncommon, benign, and usually self-limiting condition caused by low cerebrospinal fluid (CSF) pressure, usually due to CSF leakage. The dominant clinical finding is an orthostatic headache. Other common clinical features include fever, nausea, vomiting, and tinnitus.Magnetic resonance imaging (MRI) plays an important role in the diagnosis and follow-up of patients with IH. Specific MRI findings include intracranial pachymeningeal enhancement, sagging of the brain, pituitary enlargement, and subdural fluid collections.Intracranial hypotension can mimic other conditions such as aseptic meningitis or pituitary adenomas. Differential diagnosis is important, because misdiagnosis may lead to unnecessary procedures and prolonged morbidity.

Spontaneous Intracranial Hypotension with a Reversible Splenial Lesion after Swimming

“…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 ).…”

Intra- und paraselläre Prozesse – eine Übersicht

“…7)[17]. Rahmen eines Liquorunterdrucksyndroms wird eine Volumenzunahme mit homogenem Enhancement der Hypophyse beobachtet[24]. Nach erfolgreicher Therapie sind die nicht durch einen Tumor bedingten Größenzunahmen der Hypophyse reversibel[17].…”

A Case of Intracranial Hypotension after Horse Riding

“…IH is usually a self-limiting disease caused by CSF leakage 5. It is reported that spinal epidural fluid collection has a sensitivity of 67–100% or diagnosing IH based on MRI findings 6.…”

“…It is reported that spinal epidural fluid collection has a sensitivity of 67–100% or diagnosing IH based on MRI findings 6. Although hydration and analgesic treatment is sufficient in most cases, the application of an intrathecal epidural blood patch may be necessary 5…”