Spontaneous Intracranial Hypotension due to Spinal CSF Leak: Clinical Manifestations, Imaging Diagnostics and Management
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Background: Spontaneous intracranial hypotension is virtually always the result of spontaneous leaks in cerebrospinal fluid (CSF) and is recognized to cause orthostatic headaches. Spontaneous intracranial hypotension is more frequently identified in practice; the number of atypical, unconfirmed, and doubtful cases is also growing, as are treatment failures.
Objective: This literature review serves doctors with a tool to diagnose, assess, and treat patients with spontaneous intracranial hypotension caused by spinal CSF leaks.
Methods: The materials used in this review are based on a review of clinicalkey journal articles and accessing deepdyve allowing the retrieval of materials from 1993 to 2021 using the terms spontaneous intracranial hypotension, CSF leak, and low pressure headache.
Results: The clinical spectrum of spontaneous intracranial hypotension caused by CSF leaks is expanding. However, orthostatic headache is the leading manifestation. There are also typical magnetic resonance imaging findings that can be seen. Furthermore, myelography is the study of choice to locate the leak site. Management of this condition includes bed rest, epidural blood patching, percutaneous placement of fibrin sealant, and surgical repair of CSF leaks. In most cases, epidural blood patching is the mainstay treatment, but surgical techniques that are also implemented more often consist of ligation or clipping of the related nerve root sleeve diverticula leak in the case of patients who are resistant to blood patching.
Background: Spontaneous intracranial hypotension is virtually always the result of spontaneous leaks in cerebrospinal fluid (CSF) and is recognized to cause orthostatic headaches. Spontaneous intracranial hypotension is more frequently identified in practice; the number of atypical, unconfirmed, and doubtful cases is also growing, as are treatment failures. Objective: This literature review serves doctors with a tool to diagnose, assess, and treat patients with spontaneous intracranial hypotension caused by spinal CSF leaks. Methods: The materials used in this review are based on a review of clinicalkey journal articles and accessing deepdyve allowing the retrieval of materials from 1993 to 2021 using the terms spontaneous intracranial hypotension, CSF leak, and low pressure headache. Results: The clinical spectrum of spontaneous intracranial hypotension caused by CSF leaks is expanding. However, orthostatic headache is the leading manifestation. There are also typical magnetic resonance imaging findings that can be seen. Furthermore, myelography is the study of choice to locate the leak site. Management of this condition includes bed rest, epidural blood patching, percutaneous placement of fibrin sealant, and surgical repair of CSF leaks. In most cases, epidural blood patching is the mainstay treatment, but surgical techniques that are also implemented more often consist of ligation or clipping of the related nerve root sleeve diverticula leak in the case of patients who are resistant to blood patching. 35
Background: Spontaneous intracranial hypotension is virtually always the result of spontaneous leaks in cerebrospinal fluid (CSF) and is recognized to cause orthostatic headaches. Spontaneous intracranial hypotension is more frequently identified in practice; the number of atypical, unconfirmed, and doubtful cases is also growing, as are treatment failures. Objective: This literature review serves doctors with a tool to diagnose, assess, and treat patients with spontaneous intracranial hypotension caused by spinal CSF leaks. Methods: The materials used in this review are based on a review of clinicalkey journal articles and accessing deepdyve allowing the retrieval of materials from 1993 to 2021 using the terms spontaneous intracranial hypotension, CSF leak, and low pressure headache. Results: The clinical spectrum of spontaneous intracranial hypotension caused by CSF leaks is expanding. However, orthostatic headache is the leading manifestation. There are also typical magnetic resonance imaging findings that can be seen. Furthermore, myelography is the study of choice to locate the leak site. Management of this condition includes bed rest, epidural blood patching, percutaneous placement of fibrin sealant, and surgical repair of CSF leaks. In most cases, epidural blood patching is the mainstay treatment, but surgical techniques that are also implemented more often consist of ligation or clipping of the related nerve root sleeve diverticula leak in the case of patients who are resistant to blood patching. 35
Background: Spontaneous intracranial hypotension is virtually always the result of spontaneous leaks in cerebrospinal fluid (CSF) and is recognized to cause orthostatic headaches. Spontaneous intracranial hypotension is more frequently identified in practice; the number of atypical, unconfirmed, and doubtful cases is also growing, as are treatment failures. Objective: This literature review serves doctors with a tool to diagnose, assess, and treat patients with spontaneous intracranial hypotension caused by spinal CSF leaks. Methods: The materials used in this review are based on a review of clinicalkey journal articles and accessing deepdyve allowing the retrieval of materials from 1993 to 2021 using the terms spontaneous intracranial hypotension, CSF leak, and low pressure headache. Results: The clinical spectrum of spontaneous intracranial hypotension caused by CSF leaks is expanding. However, orthostatic headache is the leading manifestation. There are also typical magnetic resonance imaging findings that can be seen. Furthermore, myelography is the study of choice to locate the leak site. Management of this condition includes bed rest, epidural blood patching, percutaneous placement of fibrin sealant, and surgical repair of CSF leaks. In most cases, epidural blood patching is the mainstay treatment, but surgical techniques that are also implemented more often consist of ligation or clipping of the related nerve root sleeve diverticula leak in the case of patients who are resistant to blood patching. 35
Background: Spontaneous intracranial hypotension is virtually always the result of spontaneous leaks in cerebrospinal fluid (CSF) and is recognized to cause orthostatic headaches. Spontaneous intracranial hypotension is more frequently identified in practice; the number of atypical, unconfirmed, and doubtful cases is also growing, as are treatment failures. Objective: This literature review serves doctors with a tool to diagnose, assess, and treat patients with spontaneous intracranial hypotension caused by spinal CSF leaks. Methods: The materials used in this review are based on a review of clinicalkey journal articles and accessing deepdyve allowing the retrieval of materials from 1993 to 2021 using the terms spontaneous intracranial hypotension, CSF leak, and low pressure headache. Results: The clinical spectrum of spontaneous intracranial hypotension caused by CSF leaks is expanding. However, orthostatic headache is the leading manifestation. There are also typical magnetic resonance imaging findings that can be seen. Furthermore, myelography is the study of choice to locate the leak site. Management of this condition includes bed rest, epidural blood patching, percutaneous placement of fibrin sealant, and surgical repair of CSF leaks. In most cases, epidural blood patching is the mainstay treatment, but surgical techniques that are also implemented more often consist of ligation or clipping of the related nerve root sleeve diverticula leak in the case of patients who are resistant to blood patching. 35
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
spontaneous Intracranial Hypotension due to Spinal CSF Leak, spontaneous Intracranial Hypotension due to Spinal CSF Leak, Clinical manifestations, imaging diagnostics, and treatment.