Radionuclide cisternography in intracranial hypotension syndrome

2002 ◽  
Vol 16 (1) ◽  
pp. 75-78 ◽  
Author(s):  
Jingming Bai ◽  
Kunihiko Yokoyama ◽  
Seigo Kinuya ◽  
Shota Konishi ◽  
Takatoshi Michigishi ◽  
...  
Keyword(s):  
Intracranial Hypotension ◽  
Radionuclide Cisternography ◽  
Intracranial Hypotension Syndrome

Acquired Chiari I malformation secondary to spontaneous spinal cerebrospinal fluid leakage and chronic intracranial hypotension syndrome in seven cases

1998 ◽  
Vol 88 (2) ◽  
pp. 237-242 ◽  
Author(s):  
John L. D. Atkinson ◽  
Brian G. Weinshenker ◽  
Gary M. Miller ◽  
David G. Piepgras ◽  
Bahram Mokri
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Hypotension ◽  
Chiari I Malformation ◽  
Csf Leak ◽  
Cerebrospinal Fluid Leakage ◽  
Content Type ◽  
Intracranial Hypotension Syndrome ◽  
Csf Leakage ◽  
Chiari I ◽  
Fine Print

Object. Spontaneous spinal cerebrospinal fluid (CSF) leakage with development of the intracranial hypotension syndrome and acquired Chiari I malformation due to lumbar spinal CSF diversion procedures have both been well described. However, concomitant presentation of both syndromes has rarely been reported. The object of this paper is to present data in seven cases in which both syndromes were present. Three illustrative cases are reported in detail. Methods. The authors describe seven symptomatic cases of spontaneous spinal CSF leakage with chronic intracranial hypotension syndrome in which magnetic resonance (MR) images depicted dural enhancement, brain sagging, loss of CSF cisterns, and acquired Chiari I malformation. Conclusions. This subtype of intracranial hypotension syndrome probably results from chronic spinal drainage of CSF or high-flow CSF shunting and subsequent loss of brain buoyancy that results in brain settling and herniation of hindbrain structures through the foramen magnum. Of 35 cases of spontaneous spinal CSF leakage identified in the authors' practice over the last decade, MR imaging evidence of acquired Chiari I malformation has been shown in seven. Not to be confused with idiopathic Chiari I malformation, ideal therapy requires recognition of the syndrome and treatment directed to the site of the spinal CSF leak.

Postural Headache In A Patient With Marfan's Syndrome

Cephalalgia ◽  
2003 ◽  
Vol 23 (7) ◽  
pp. 552-555 ◽  
Author(s):  
E Ferrante ◽  
A Citterio ◽  
A Savino ◽  
P Santalucia
Keyword(s):  
Intracranial Hypotension ◽  
Brain Mri ◽  
Spontaneous Intracranial Hypotension ◽  
Csf Leak ◽  
Marfan’S Syndrome ◽  
Marfan's Syndrome ◽  
Postural Headache ◽  
Intracranial Hypotension Syndrome ◽  
Increased Risk ◽  
Diffuse Pachymeningeal Enhancement

A 26-year-old man with Marfan's syndrome had postural headache. Brain MRI with gadolinium showed diffuse pachymeningeal enhancement. MRI myelography revealed bilateral multiple large meningeal diverticula at sacral nerve roots level. He was suspected to have spontaneous intracranial hypotension syndrome. Eight days later headache improved with bed rest and hydration. One month after the onset he was asymptomatic and 3 months later brain MRI showed no evidence of diffuse pachymeningeal enhancement. The 1-year follow-up revealed no neurological abnormalities. The intracranial hypotension syndrome likely resulted from a CSF leak from one of the meningeal diverticula. In conclusion patients with spinal meningeal diverticula (frequently seen in Marfan's syndrome) might be at increased risk of developing CSF leaks, possibly secondary to Valsalva maneuver or minor unrecognizedtrauma.

scholarly journals Abducens nerve paresis in spontaneous intracranial hypotension syndrome.

2005 ◽  
Vol 83 (2) ◽  
pp. 269-270 ◽  
Author(s):  
Matthias Grueb ◽  
Dorothea Besch ◽  
Joerg Mielke ◽  
Eva Reinthal ◽  
Volker Herzau
Keyword(s):  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension ◽  
Abducens Nerve ◽  
Intracranial Hypotension Syndrome ◽  
Nerve Paresis

Diagnostic and surgical strategies for intractable spontaneous intracranial hypotension

2001 ◽  
Vol 94 (4) ◽  
pp. 642-645 ◽  
Author(s):  
Chikanori Inenaga ◽  
Tokutaro Tanaka ◽  
Naoki Sakai ◽  
Shigeru Nishizawa
Keyword(s):  
Computerized Tomography ◽  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension ◽  
Upright Position ◽  
Breath Holding ◽  
Content Type ◽  
Radionuclide Cisternography ◽  
Csf Leakage ◽  
Upper Cervical ◽  
Fine Print

✓ The authors present the case of a 55-year-old man suffering from intractable spontaneous intracranial hypotension, in whom conservative treatment with 19 weeks of bed rest was not effective. In this period the patient twice underwent surgery for bilateral chronic subdural hematoma, a complication of spontaneous intracranial hypotension. Conventional radionuclide cisternography, magnetic resonance imaging, and computerized tomography myelography did not demonstrate cerebrospinal fluid (CSF) leakage. Repeated radionuclide cisternography with the patient in an upright position revealed leakage of the tracer at upper cervical levels. Computerized tomography myelography with breath holding also showed CSF leakage of the contrast medium bilaterally at upper cervical levels. The patient underwent surgery, and bilateral C-2 and C-3 spinal nerve root pouches were sealed off from the subarachnoid space with oxidized cellulose cotton and fibrin glue. Epiarachnoid spaces around the root sleeves were also sealed to ensure complete resolution of the CSF leakage. After the surgery, the patient was completely free of the disease. In the case of intractable persistent spontaneous intracranial hypotension, surgical treatment is preferable to long-term conservative management. To identify CSF leakage, radionuclide cisternography with the patient in the upright position is useful. When obvious leakage is encountered, surgical sealing of the lesion should be performed via a subarachnoid approach.

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