First‐line steroid treatment for spontaneous intracranial hypotension

Tonello, Simone; Grossi, Ugo; Trincia, Elena; Zanus, Giacomo

doi:10.1111/ene.15195

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…However, the ideal duration, type, dose, and route of administration of hormones are still inconclusive; however, the majority of patients could have symptom relief within days of administration[ 17 ]. Hormones may exert their pharmacological effects by: (1) Ameliorating brain edema and inhibiting inflammation caused by brain herniation; (2) Inhibiting meningeal inflammation and that of CSF cells or proteins, thus reducing CSF leakage; (3) Inhibiting excessive absorption of CSF; and (4) Promoting reabsorption of CSF from the epidural space and increasing the overall CSF volume[ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Rare cause of cerebral venous sinus thrombosis: Spontaneous intracranial hypotension syndrome: A case report

Huang¹

2023

World J Clin Cases

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BACKGROUND Spontaneous intracranial hypotension syndrome is a relatively uncommon neurological disorder of unknown etiology with a good prognosis. Cerebral venous sinus thrombosis is a specific type of cerebrovascular disease caused by multiple etiologies of cerebral venous sinus or vein thrombosis that obstructs cerebral venous return and is associated with impaired cerebrospinal fluid absorption; this entity is rarely seen clinically. Spontaneous intracranial hypotension syndrome is one of the causes of cerebral venous sinus thrombosis, and the probability of their combined occurrence is only 1%-2%. As such, it is easily overlooked clinically, thus increasing the difficulty of diagnosis and treatment. CASE SUMMARY A 29-year-old young woman presented with postural headache. Lumbar puncture suggested a pressure of 50 mmH 2 O (normal 80 mmH 2 O-180 mmH 2 O), and magnetic resonance imaging cerebral venography suggested thrombosis of the supratentorial sinus. These findings were considered indicative of cerebral venous sinus thrombosis due to spontaneous intracranial hypotension syndrome after ruling out immunological causes, tumor, infection, abnormal coagulation mechanism, and hypercoagulable state, etc. She was treated with rehydration and low-molecular heparin anticoagulation for 15 d, and follow-up magnetic resonance imaging cerebral venography suggested resolution of the thrombus. The patient had complete improvement of her headache symptoms. CONCLUSION Spontaneous intracranial hypotension syndrome is one of the rare causes of cerebral venous sinus thrombosis, which is frequently misdiagnosed or missed and deserves consideration by clinicians during differential diagnosis. Dehydration should be avoided in such patients, and early rehydration and anticoagulation therapy are effective treatment options.

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Section: Discussionmentioning

confidence: 99%

Rare cause of cerebral venous sinus thrombosis: Spontaneous intracranial hypotension syndrome: A case report

Huang¹

2023

World J Clin Cases

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“…Antiemetics may be required for symptomatic management of nausea and vomiting [14]. Prospective, randomized studies are needed to establish the safety and effectiveness of steroids to avoid the need for more invasive treatments [25].…”

Section: Non-invasive Options For Treatmentmentioning

confidence: 99%

How to find and overcome reason of the pain - an overview of the possible approaches in intracranial hypotension treatment

Hądzlik,

Piotrowski,

Biały-Karbowniczek

et al. 2024

J Educ Health Sport

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Intracranial hypotension syndrome develops following cerebrospinal fluid (CSF, cerebrospinal fluid) leakage as a result of iatrogenic or spontaneous interruption of the meninges. The main clinical manifestation of intracranial hypotension, whether spontaneous (SIH, spontaneous intracranial hypotension) or iatrogenic, is a chronic headache of the orthostatic type, which may be accompanied by symptoms of neurological deficits. Despite the usually benign course, subdural haematomas developing following SIH or cerebral venous sinus thrombosis can cause deterioration of the patient's condition and may even be life-threatening. An important role in the diagnosis of SIH is played by imaging studies (mainly magnetic resonance imaging) of the brain and spinal canal, sometimes supplemented by CSF pressure testing. If conservative treatment fails, consideration should be given to surgical management and epidural blood patch. SIH is dangerous, so it is important to know how to diagnose and treat it.

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“…Spontaneous intracranial hypotension (SIH) is a debilitating condition that occurs spontaneously secondary to cerebrospinal fluid (CSF) leak and/or CSF hypotension (lumbar puncture opening pressure <60 mm CSF) and typically manifests as orthostatic headache associated with nausea, vomiting, tinnitus, vertigo, hypoacusis, neck pain/stiffness, and photophobia. [ 1 , 2 ] Treatment options include bed rest, hydration, caffeine, analgesics, epidural blood patch (EBP), [ 3 , 4 ] steroids, [ 5 , 6 ] fibrin glue (N-butyl-cyanoacrylate), [ 7 , 8 ] and surgical repair. [ 9 , 10 ] In this series, we report two cases, who presented to us with features of SIH and were managed successfully with sphenopalatine ganglion (SPG) block.…”

Section: Introductionmentioning

confidence: 99%

Sphenopalatine ganglion block for the treatment of spontaneous intracranial hypotension without demonstrable cerebrospinal fluid leak: A report of two cases

Khandelwal,

Sarma,

Hussain

2024

JNRP

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Spontaneous intracranial hypotension (SIH) is a condition characterized by orthostatic headache associated with nausea, vomiting, tinnitus, vertigo, hypoacusis, neck pain/stiffness, and photophobia. Usual treatment includes bed rest, hydration, caffeine, analgesics, epidural blood patch, steroids, fibrin glue (N-butyl-cyanoacrylate), and surgical repair. In this series, we report two cases, who presented to us with features of SIH and were managed successfully with sphenopalatine ganglion block. This is a novel modality of management of SIH and has not been reported before.

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First‐line steroid treatment for spontaneous intracranial hypotension

Cited by 6 publications

References 5 publications

Rare cause of cerebral venous sinus thrombosis: Spontaneous intracranial hypotension syndrome: A case report

Rare cause of cerebral venous sinus thrombosis: Spontaneous intracranial hypotension syndrome: A case report

How to find and overcome reason of the pain - an overview of the possible approaches in intracranial hypotension treatment

Sphenopalatine ganglion block for the treatment of spontaneous intracranial hypotension without demonstrable cerebrospinal fluid leak: A report of two cases

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