Iatrogenic intracranial hypotension and cerebral venous thrombosis

Endovascular Recanalization of Life-Threatening Cerebral Venous Thrombosis Secondary to Iatrogenic Intracranial Hypotension

“…Thus, CVT secondary to IH reportedly involved a more rapid and severe course illness, including higher rates for venous infarction, and National Institutes of Health Stroke Scale score than those of CVT not associated with IH. 2 In terms of treatment for CVT secondary to IH, treatment consensus is lacking. However, priority was given to CVT treatment in most previously reported cases, because IH was thought to have a benign course but CVT was considered life-threatening.…”

“…3 In addition, CVT secondary to IH had a higher tendency to involve the large cerebral venous sinus and exhibited severe symptoms. 2 Thus, anticoagulation alone may not be useful for acute deteriorating CVT involving the large venous sinus secondary to IH.…”

“…1 Especially, it has been known that CVT secondary to IH have involve the large cerebral venous sinus with a more acute and severe course. 2 Currently, anticoagulation has been mainstay for treatment for CVT. However, according to latest study, 3 vascular recanalization started within the first 8 days of therapeutic anticoagulation.…”

Cerebral Blood Flow in Low Intracranial Pressure Headaches—What Is Known?

“…Thus, increases in CBF may be the mechanism by which patients with normal pressure hydrocephalus who are shunted improve [47]. Honig et al assessed the manifestations of cerebral venous thrombosis (CVT) associated with IH following lumbar punctures or spinal anesthesia [26]. IH was diagnosed in 11/42 (26%) of CVT patients.…”

“…Stretching of the cerebral vessels may lead to traumatic damage of the venous endothelial and contribute to CVT and subdural collection formation. Moreover, CVT formation may be aggravated by hypercoagulopathy [26]. Schmidt et al measured cerebral hemodynamic changes induced by a lumbar puncture in good-grade subarachnoid hemorrhages (SAH).…”