Headache in spontaneous intracranial hypotension: an overview with indications for differential diagnosis in the clinical practice

D’Amico, Domenico; Usai, Susanna; Chiapparini, Luisa; Erbetta, Alessandra; Gioppo, Andrea; Messina, Giuseppe; Astengo, A; Leone, Massimo

doi:10.1007/s10072-020-04642-9

Cited by 10 publications

(8 citation statements)

References 28 publications

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“…the strongest theory states that a normal brain (weighing 1500 grams) weighs only 48 grams when surrounded by an appropriate amount of CSF [5] . A decrease in CSF pressure increases traction in pain-sensitive tissues, which is at its maximum in the standing position [6] .…”

Section: Case Reportmentioning

confidence: 99%

A notable improvement in spontaneous intracranial hypotension (SIH) after delivery in a pregnant woman: A case report

Reihani

Zarei

Soltani

et al. 2022

Radiology Case Reports

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Section: Case Reportmentioning

confidence: 99%

A notable improvement in spontaneous intracranial hypotension (SIH) after delivery in a pregnant woman: A case report

Reihani

Zarei

Soltani

et al. 2022

Radiology Case Reports

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“…Краниалгия может быть диффузной или может быть локализована в лобно-височных областях или чаще -в затылочной области. По характеру боль может быть пульсирующей, стреляющей, ноющей или по типу «громового удара» [3,8,19]. Тяжесть головной боли варьируется в широких пределах -от легкой до выраженной, с ограничением любой физической активности.…”

Section: этиология и патогенезunclassified

Спонтанная Внутричерепная Гипотензия (Клинические Наблюдения И Разбор Литературы)

Sa¹,

Астапенко²,

Terekhov³

et al. 2021

Неврология И Нейрохирургия. Восточная Европа

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Спонтанная внутричерепная гипотензия (спонтанная ликворная гипотензия) - это редкий патологический синдром, возникающий в результате снижения давления спинномозговой жидкости ниже 50 мм вод. ст. Характерным клиническим признаком является позиционно зависимая головная боль, возникающая в течение 15-20 минут после вертикализации пациента. Особенностью этой боли является то, что она значительно уменьшается или вовсе проходит вгоризонтальном положении. Основной метод диагностики спонтанной внутричерепной гипотензии - магнитно-резонансная томография. В частности, миелография в настоящее время является самым достоверным методом для определения местоположения дефекта твердой мозговой оболочки и степени утечки ликвора. В статье приведены данные об эпидемиологии, патофизиологии, клинической картине, диагностике и методах лечения спонтанной ликворной гипотензии. Представлены собственные клинические наблюдения трех пациентов с синдромом спонтанной внутричерепной гипотензии. Spontaneous intracranial hypotension (spontaneous cerebrospinal fluid hypotension) is a rare pathological syndrome resulting from the decrease of the pressure of cerebrospinal fluid in the dural sac below 50 mm water column. A typical clinical sign is a positional headache that occurs within 15-20 minutes after the patient is upright. A feature of this pain is that it is significantly reduced or completely disappears in a horizontal position. The main method for diagnosing spontaneous intracranial hypotension is magnetic resonance imaging. In particular, myelography is currently the most reliable method for determining the location of the dura mater defect and the extent of CSF leakage. The article provides data on epidemiology, pathophysiology, clinical presentation, diagnosis, and treatment methods in spontaneous cerebrospinal fluid hypotension. We present our own clinical observations of three patients with spontaneous intracranial hypotension syndrome.

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“…6 For patients presenting with pure orthostatic headache, positional tachycardia, and no history of migraine, a diagnosis of spontaneous intracranial hypotension should be considered. 7,8 This narrative review addresses how the pathophysiology of POTS may inform treatment of patients with POTS and migraine. The first section reviews the pathophysiology and clinical characteristics of POTS subtypes.…”

Section: Introductionmentioning

confidence: 99%

Postural orthostatic tachycardia syndrome and migraine: A narrative review

Mueller

Robinson‐Papp

2022

Headache

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Objective In this narrative review, we summarize experimental and clinical evidence demonstrating mechanistic connections between POTS and migraine. Background Migraine is the most common comorbidity in patients with POTS, a heterogenous disorder of the autonomic nervous system characterized by orthostatic intolerance and positional tachycardia. POTS is a debilitating illness with few effective treatments. We aim for this narrative review to increase awareness of the mechanistic connections between POTS and migraine providing foundational information that optimizes clinical care and advances the development of pathophysiologic‐based treatments. Methods We used the PubMed and Medline databases in November 2021 to perform a literature review and searched for the following keywords: “postural orthostatic tachycardia syndrome,” “POTS,” “autonomic nervous system,” AND “migraine,” “headache.” Results The high prevalence of migraine in patients with POTS may be explained by common pathologic mechanisms. There is evidence that dysregulation of the sympathetic nervous system, alterations in central and peripheral hemodynamics, and central sensitization increase vulnerability to both POTS and migraine. Non‐pharmacologic and pharmacologic treatments that target these shared mechanisms may provide significant benefit for the patient with POTS and migraine. Conclusions Identification of common affected pathways may provide important insight that advances our understanding and treatment of both migraine and POTS.

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Headache in spontaneous intracranial hypotension: an overview with indications for differential diagnosis in the clinical practice

Cited by 10 publications

References 28 publications

A notable improvement in spontaneous intracranial hypotension (SIH) after delivery in a pregnant woman: A case report

A notable improvement in spontaneous intracranial hypotension (SIH) after delivery in a pregnant woman: A case report

Спонтанная Внутричерепная Гипотензия (Клинические Наблюдения И Разбор Литературы)

Postural orthostatic tachycardia syndrome and migraine: A narrative review

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