Jeffrey Ross
The Agony of Aliquorrhea
Intracranial hypotension can occur in a variety of clinical settings and can be grouped by primary or secondary etiologies. We are generally quite familiar with the secondary type of intracranial hypotension, related to prior cranial or spinal surgery, trauma, or prior lumbar puncture, as a cause of postural headache. The primary form (aka … more »
Sait Albayram
I first met one of the patients with intracranial hypotension syndrome at Johns Hopkins Hospital during my neuroradiology research fellowship in 2000. Later on, in 2002, this case was published in AJNR.1
After finishing my research fellowship, in my clinical practice, I realized that intracranial hypotension is not a rare syndrome. There were only 40 papers … more »
Christina Wendl
Intracranial hypotension is a rare cause of persistent headache originating mostly from a dural CSF leak. Conservative treatment serves as first-line therapy, but if it fails, a minimally invasive epidural blood patch (EBP) can lead to successful sealing of such a leak. The usual treatment is a blind EBP at the lumbar level.
MRI of the … more »
Wouter I. Schievink
I saw my first patient with spontaneous intracranial hypotension in 1991 when I was a neurosurgery resident: A 22-year-old exotic dancer had been suffering with headaches for 6 weeks after a minor brawl, and she had seen a multitude of physicians. However, her head CT was normal, and no cause for the headaches … more »
Arata Watanabe
When we did our research, the findings of brain MRI had already been accumulated. However, we believed that the findings of spinal MRI should be more direct. Spontaneous intracranial hypotension (SIH) is a disease caused by CSF leakage from the spinal dural sac. When diagnosing SIH, combining spinal and brain MRI is more precise than … more »
Peter G. Kranz
Try to imagine how your life would be impacted if you were suddenly completely unable to sit up or stand at all without suffering a crushing, debilitating headache. This is the reality for many patients who suffer from spontaneous intracranial hypotension (SIH). SIH is a disease that has become much more widely recognized … more »
Patrick H. Luetmer
My initial interest in spontaneous intracranial hypotension (SIH) and localization of CSF leaks began over 10 years ago. The early work of my colleagues Drs. Gary Miller, Bahram Mokri, and David Piepgras served to increase clinical awareness and MRI recognition of SIH. We began to accrue a cohort of patients who had chronic debilitating … more »
Richard I. Farb
Gadolinium-enhanced MR venography has provided neuroradiologists with the ability to visualize the effect that altered intracranial pressure (ICP) has on the appearance of the dural venous sinuses. Specifically, the dural sinuses appear mildly compressed when ICP is elevated and will distend when ICP is abnormally low. This changing contour of the dural sinuses … more »