| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Departments of Neurology (Drs. Pannullo and Posner) and Diagnostic Radiology (Dr. Krol), Memorial Sloan-Kettering Cancer Center, and the Departments of Neurology and Neuroscience (Drs. Pannullo, Reich, and Posner) and Radiology (Dr. Deck), Cornell University Medical College, New York, NY.
We report seven patients with the syndrome of intracranial hypotension who were referred to Memorial Sloan-Kettering, primarily because of suspicion of meningeal tumor or infection raised by the finding of meningeal enhancement on MRI. In three patients, symptoms occurred after lumbar puncture; in four, there was no clear precipitating event. Lumbar puncture after MRI in six patients revealed low CSF pressure (six patients) and pleocytosis or high protein, or both (four patients). Three patients had subdural effusions. Six patients had measurable descent of the brain on midsagittal images. Postural headache resolved in all seven patients, six of whom had follow-up MRIs. Meningeal enhancement resolved or diminished in all six. Subdural effusions resolved spontaneously in two and were evacuated (but were not under pressure) in one. Downward brain displacement improved or resolved in all patients. The clinical syndrome and MRI abnormalities generally resolve on their own. An extensive workup is not helpful and may be misleading. Patients should be treated symptomatically.
Presented in part at the 44th annual meeting of the American Academy of Neurology, San Diego, CA, May 1992.
Address correspondence and reprint requests to Dr. Jerome B. Posner, 1275 York Avenue, New York, NY 10021.
Received September 1, 1992. Accepted for publication in final form September 14, 1992.
This article has been cited by other articles:
|
|
 |
|
  H.-M. Yoo, S.J. Kim, C.G. Choi, D.H. Lee, J.H. Lee, D.C. Suh, J.W. Choi, K.S. Jeong, S.J. Chung, J.S. Kim, et al. Detection of CSF Leak in Spinal CSF Leak Syndrome Using MR Myelography: Correlation with Radioisotope Cisternography AJNR Am. J. Neuroradiol., April 1, 2008; 29(4): 649 - 654. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Savoiardo, L. Minati, L. Farina, T. De Simone, D. Aquino, E. Mea, G. Filippini, G. Bussone, and L. Chiapparini Spontaneous intracranial hypotension with deep brain swelling Brain, July 1, 2007; 130(7): 1884 - 1893. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Arai, S. Matsushima, and H. Terada Divergence paresis without positional headache: an unusual presentation of cerebrospinal fluid hypovolemia after spinal anesthesia. Anesth. Analg., June 1, 2006; 102(6): 1865 - 1866. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. I. Schievink Spontaneous Spinal Cerebrospinal Fluid Leaks and Intracranial Hypotension JAMA, May 17, 2006; 295(19): 2286 - 2296. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Maurelli, R. Bergamaschi, E. Candeloro, A. Todeschini, and G. Micieli Cerebral venous thrombosis and demyelinating diseases: report of a case in a clinically isolated syndrome suggestive of multiple sclerosis onset and review of the literature Multiple Sclerosis, April 1, 2005; 11(2): 242 - 244. [Abstract] [PDF]
|
|
|
|
 |
|
 C. Siau, H. P. Ng, G. M. Tan, B. S. Ho, and H. L. Pua In vitro effects of local anaesthetics on the thromboelastographic profile of parturients Br. J. Anaesth., January 1, 2005; 94(1): 117 - 120. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Samandouras, V. Bajtajic, F. Cross, and P. J. Hamlyn Cranial Subdural Hygroma Complicating Thoracic Disc Surgery. A Case Report J. Bone Joint Surg. Am., September 1, 2004; 86(9): 2033 - 2037. [Full Text] [PDF]
|
|
|
|
 |
|
 R J de Noronha, B Sharrack, M Hadjivassiliou, and C A J Romanowski Subdural haematoma: a potentially serious consequence of spontaneous intracranial hypotension J. Neurol. Neurosurg. Psychiatry, June 1, 2003; 74(6): 752 - 755. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-G. Pirini, M. Mascalchi, F. Salvi, C. A. Tassinari, L. Zanella, P. Bacchini, F. Bertoni, A. D'Errico, B. Corti, and W. F. Grigioni Primary Diffuse Meningeal Melanomatosis: Radiologic-Pathologic Correlation AJNR Am. J. Neuroradiol., January 1, 2003; 24(1): 115 - 118. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. P. van den Berg, S. E. Sijbrandy, A. H. Meijer, and A. H. J. Oostdijk Subdural Hygroma: A Rare Complication of Spinal Anesthesia Anesth. Analg., June 1, 2002; 94(6): 1625 - 1627. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Albayram, B. A. Wasserman, D. M. Yousem, and R. Wityk Intracranial Hypotension as a Cause of Radiculopathy from Cervical Epidural Venous Engorgement: Case Report AJNR Am. J. Neuroradiol., April 1, 2002; 23(4): 618 - 621. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Koul, A. Chacko, H. Javed, R. Jain, A. Ganesh, and S. Srinivasan Syndrome of Cerebrospinal Fluid Hypovolemia Following Lumbar Puncture Cerebrospinal Fluid Leak in a Patient With Idiopathic Intracranial Hypertension J Child Neurol, January 1, 2002; 17(1): 77 - 79. [Abstract] [PDF]
|
|
|
|
|
|
Y. Segev, U. Metser, L. Beni-Adani, C. Elran, I.-I. Reider-Groswasser, and S. Constantini Morphometric Study of the Midsagittal MR Imaging Plane in Cases of Hydrocephalus and Atrophy and in Normal Brains AJNR Am. J. Neuroradiol., October 1, 2001; 22(9): 1674 - 1679. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Forderreuther, I. Yousry, M. Empl, and A. Straube Dilated cervical epidural veins and extra arachnoid fluid collection in orthostatic headaches Neurology, August 14, 2001; 57(3): 527 - 529. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Yousry, S. Forderreuther, B. Moriggl, M. Holtmannspotter, T. P. Naidich, A. Straube, and T. A. Yousry Cervical MR Imaging in Postural Headache: MR Signs and Pathophysiological Implications AJNR Am. J. Neuroradiol., August 1, 2001; 22(7): 1239 - 1250. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Mokri and J. B. Posner Spontaneous intracranial hypotension: The broadening clinical and imaging spectrum of CSF leaks Neurology, December 26, 2000; 55(12): 1771 - 1772. [Full Text] [PDF]
|
|
|
|
|
|
J. Alvarez-Linera, J. Escribano, J. Benito-Leon, J. Porta-Etessam, and A. Rovira Pituitary enlargement in patients with intracranial hypotension syndrome Neurology, December 26, 2000; 55(12): 1895 - 1897. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Mokri, J. L. D. Atkinson, and D. G. Piepgras Absent headache despite CSF volume depletion (intracranial hypotension) Neurology, December 12, 2000; 55(11): 1722 - 1724. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Chung, J. S. Kim, and M. C. Lee Syndrome of cerebral spinal fluid hypovolemia: Clinical and imaging features and outcome Neurology, November 14, 2000; 55(9): 1321 - 1327. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. L. Antunes Topical Review: Acute Neurologic Complications in Children With Systemic Cancer J Child Neurol, November 1, 2000; 15(11): 705 - 716. [Abstract] [PDF]
|
|
|
|
|
|
B. Mokri and J. L. D. Atkinson False pituitary tumor in CSF leaks Neurology, August 22, 2000; 55(4): 573 - 575. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S.-I. Pakiam, C. Lee, and A. E. Lang Intracranial Hypotension With Parkinsonism, Ataxia, and Bulbar Weakness Arch Neurol, July 1, 1999; 56(7): 869 - 872. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Mokri, J. L. D. Atkinson, D. W. Dodick, G. M. Miller, and D. G. Piepgras Absent pachymeningeal gadolinium enhancement on cranial MRI despite symptomatic CSF leak Neurology, July 1, 1999; 53(2): 402 - 402. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Brugières, Malapert, Adle-Biassette, Fuerxer, Djindjian, and Gaston Idiopathic Spinal Cord Herniation: Value of MR Phase-Contrast AJNR Am. J. Neuroradiol., May 1, 1999; 20(5): 935 - 939. [Abstract] [Full Text]
|
|
|
|
|
|
M. S. Hochman and T. P. Naidich Diffuse meningeal enhancement in patients with overdraining, long-standing ventricular shunts Neurology, January 1, 1999; 52(2): 406 - 406. [Abstract] [Full Text]
|
|
|
|
|
|
R. Sakakibara, T. Hattori, T. Fukutake, M. Mori, T. Yamanishi, and K. Yasuda Micturitional disturbance in herpetic brainstem encephalitis; contribution of the pontine micturition centre J. Neurol. Neurosurg. Psychiatry, February 1, 1998; 64(2): 269 - 272. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. H. O'Leary and S. de la Monte Case 2-1998- A 50-Year-Old Woman with Increasing Headache and a Left Abducent-Nerve Palsy N. Engl. J. Med., January 15, 1998; 338(3): 180 - 188. [Full Text] [PDF]
|
|
|
|
|
|
E. Wilder-Smith, I. Kothbauer-Margreiter, B. Lammle, M. Sturzenegger, C. Ozdoba, and S. P Hauser Dural puncture and activated protein C resistance: risk factors for cerebral venous sinus thrombosis J. Neurol. Neurosurg. Psychiatry, September 1, 1997; 63(3): 351 - 356. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
