| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Departments of Neurology (Dr. Mokri), Laboratory Medicine and Pathology (Drs. Parisi and Scheithauer), Neurologic Surgery (Dr. Piepgras), and Diagnostic Radiology (Dr. Miller), Mayo Clinic and Mayo Foundation, Rochester, MN.
Received October 13, 1994. Accepted in final form February 23, 1995.
Address correspondence and reprint requests to Dr. B. Mokri, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
Intracranial hypotension is a cause of diffuse enhancement of the pachymeninx with gadolinium, which often is associated with subdural fluid collections.We reviewed the results of meningeal biopsy in six patients with intracranial hypotension and diffuse pachymeningeal enhancement to correlate the MRI findings with histopathologic observations and to explain the abnormalities seen on MRI. Grossly, the dura mater was unremarkable in all patients, as were the leptomeninges, except for one patient with prolonged (18 months) intracranial hypotension in whom the arachnoid was thickened and opaque. Microscopically, the dura mater was entirely normal on its epidural aspect; however, a fairly thin zone of fibroblasts and thin-walled small blood vessels in an amorphous matrix was noted on the subdural aspect. In the patient with longstanding symptoms, diffuse benign arachnoidal cell proliferation was also noted, probably a reaction triggered by longstanding changes in the subdural area, as noted in the five other patients. There was no evidence of inflammation, infection, or metastatic neoplasia. These findings suggest that in intracranial hypotension, the dural-meningeal abnormalities probably represent reactive secondary phenomena, likely related to hydrostatic changes in the CSF, and not a primary meningeal process.
NEUROLOGY 1995;45: 1801-1807
This article has been cited by other articles:
|
|
 |
|
  M. Tosaka, N. Sato, H. Fujimaki, Y. Tanaka, K. Kagoshima, A. Takahashi, N. Saito, and Y. Yoshimoto Diffuse Pachymeningeal Hyperintensity and Subdural Effusion/Hematoma Detected by Fluid-Attenuated Inversion Recovery MR Imaging in Patients with Spontaneous Intracranial Hypotension AJNR Am. J. Neuroradiol., June 1, 2008; 29(6): 1164 - 1170. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S V Ahmed, C Jayawarna, and E Jude Post lumbar puncture headache: diagnosis and management Postgrad. Med. J., November 1, 2006; 82(973): 713 - 716. [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]
|
|
|
|
 |
|
 I. Almazov and N. Brand Meningismus is a Commonly Overlooked Finding in Tension-Type Headache in Children and Adolescents J Child Neurol, May 1, 2006; 21(5): 423 - 425. [Abstract] [PDF]
|
|
|
|
|
|
E. Farag, A. Abdou, I. Riad, S. R. Borsellino, and A. Schubert Cerebellar Hemorrhage Caused by Cerebrospinal Fluid Leak After Spine Surgery Anesth. Analg., February 1, 2005; 100(2): 545 - 546. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.J. Kupersmith, V. Martin, G. Heller, A. Shah, and H.J. Mitnick Idiopathic hypertrophic pachymeningitis Neurology, March 9, 2004; 62(5): 686 - 694. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. K. Turnbull and D. B. Shepherd Post-dural puncture headache: pathogenesis, prevention and treatment Br. J. Anaesth., November 1, 2003; 91(5): 718 - 729. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Koss, J. L. Ulmer, and L. Hacein-Bey Angiographic Features of Spontaneous Intracranial Hypotension AJNR Am. J. Neuroradiol., April 1, 2003; 24(4): 704 - 706. [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]
|
|
|
|
 |
|
 G J LUIJCKX and T DE JAEGERE Magnetic resonance imaging findings before and after treatment of spontaneous intracranial hypotension J. Neurol. Neurosurg. Psychiatry, September 1, 2001; 71(3): 411 - 411. [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]
|
|
|
|
 |
|
 E. T. Wong and D. N. Louis Case 8-2001- A 61-Year-Old Man with Transient Quadriplegia and Apnea N. Engl. J. Med., March 15, 2001; 344(11): 832 - 839. [Full Text] [PDF]
|
|
|
|
|
|
F. Clarot, F. Callonnec, F. Douvrin, D. Hannequin, J. Simonet, B. Proust, and J. Thiébot Giant Cervical Epidural Veins after Lumbar Puncture in a Case of Intracranial Hypotension AJNR Am. J. Neuroradiol., April 1, 2000; 21(4): 787 - 789. [Abstract] [Full Text]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
