Lubdha M. Shah
Troy A. Hutchins
Miriam E. Peckham
Spontaneous intracranial hypotension (SIH), caused by CSF leak along the spine, can be challenging to diagnose and treat. The classic patient with SIH will present … more »
March-April 2020
Renal Contrast on CT Myelography: Diagnostic Value in Patients with Spontaneous Intracranial Hypotension
Jared Verdoorn
We chose this research topic because several spine neuroradiologists in our practice had anecdotally noted contrast present in the renal collecting systems when performing CT myelography in patients with spontaneous intracranial hypotension (SIH), and this was not noticed in patients undergoing CT myelography for other indications. We wondered if it was a … more »
The Interpeduncular Angle: A Practical and Objective Marker for the Detection and Diagnosis of Intracranial Hypotension on Brain MRI
Manas Sharma
Intracranial hypotension is a neurologic syndrome with various etiologies that share a common final pathway of decreased CSF volume and pressure. The classic clinical presentation is orthostatic headache with nonspecific symptoms like nausea and vertigo.1,2 Severe cases can progress to cranial nerve palsies and coma.3 The nonspecific nature of the clinical presentation … more »
Decubitus CT Myelography for Detecting Subtle CSF Leaks in Spontaneous Intracranial Hypotension
Peter G. Kranz
The discovery of CSF venous fistulas (CVFs) as a cause of spontaneous intracranial hypotension (SIH) has had a profound impact on treatment.1 Patients with no visible epidural fluid leakage who were once thought to have slow-flow leaks are increasingly recognized as harboring CVFs. The diagnosis of CVF is important because these patients … more »
Spontaneous Intracranial Hypotension: A Systematic Imaging Approach for CSF Leak Localization and Management Based on MRI and Digital Subtraction Myelography
Richard I. Farb
The syndrome of spontaneous intracranial hypotension (SIH) represents a significant recent challenge for neuroradiology because it relies heavily on imaging for diagnosis and management. Since the imaging findings of SIH were first described on MRI,1 there have been many articles on the intracranial imaging findings associated with SIH. Although an empiric … more »
Lateral Decubitus Digital Subtraction Myelography: Tips, Tricks, and Pitfalls
Dong Kun Kim
Our institution has a very active practice on the diagnosis and treatment of spontaneous intracranial hypotension. Our neuroradiology division has a group of 9 neuroradiologists who routinely perform diagnostic procedures and therapeutic interventions specific to spontaneous spinal CSF leak (SSCSFL). We also have a headache clinic run by the neurology department … more »