Magnetic Resonance-Guided Diagnosis of Spontaneous Intracranial Hypotension in a Middle-Aged Woman

xlomafota13 shared this article with you from Inoreader Magnetic Resonance-Guided Diagnosis of Spontaneous Intracranial Hypotension in a Middle-Aged Woman Via leak of cerebrospinal fluid Case Rep Neurol Med. 2022 Feb 21;2022:4438923. doi: 10.1155/2022/4438923. eCollection 2022. ABSTRACT Spontaneous intracranial hypotension (SIH) is a rare condition caused by a cerebrospinal fluid (CSF) leak. It is diagnosed by clinical features that include an orthostatic headache combined with imaging findings demonstrating intracranial hypotension and a CSF leak. We present the case of a 45-year-old woman with an orthostatic headache who was found to have a sagging brain with a downward-displaced cerebellum and pachymeningeal enhancement with gadolinium contrast. This was initially misidentified as a Chiari I malformation, but the constellation of symptoms and MRI findings were later recognized as characteristic of SIH. Diagnosis of SIH and a CSF leak was confirmed with CT myelography. She was treated with a nontarget epidural blood patch, and her symptoms resolved. An orthostatic headache, a sagging brain, and pachymeningeal enhance ment on MRI are highly specific for SIH, raising suspicion for this uncommon and often missed diagnosis. PMID:35237456 | PMC:PMC8885260 | DOI:10.1155/2022/4438923 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.