Spontaneous Intracranial Hypotension Associated with Subdural Hematoma: Diagnostic Usefulness of Percutaneous Subdural Tapping and Magnetic Resonance Imaging

1998 ◽  
Vol 140 (1) ◽  
pp. 47-50 ◽  
Author(s):  
N. Aoki ◽  
T. Sakai ◽  
A. Oikawa
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Subdural Hematoma ◽  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension ◽  
Resonance Imaging ◽  
Diagnostic Usefulness ◽  
Subdural Tapping

Magnetic resonance imaging in spontaneous intracranial hypotension

2004 ◽  
Vol 1259 ◽  
pp. 375-379 ◽  
Author(s):  
Mineko Murakami ◽  
Akira Matsuno ◽  
Michi Nakashima ◽  
Hideki Tanaka ◽  
Haruko Katayama ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension ◽  
Resonance Imaging

Correlations among brain and spinal MRI findings in spontaneous intracranial hypotension

Cephalalgia ◽  
2018 ◽  
Vol 38 (14) ◽  
pp. 1998-2005 ◽  
Author(s):  
Jr-Wei Wu ◽  
Yen-Feng Wang ◽  
Jong-Ling Fuh ◽  
Jiing-Feng Lirng ◽  
Shih-Pin Chen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension ◽  
Brain Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid Leak ◽  
Resonance Imaging ◽  
Imaging Signs ◽  
Fluid Leak

Objectives Several brain and spinal magnetic resonance imaging signs have been described in spontaneous intracranial hypotension. Their correlations are not fully studied. This study aimed to explore potential mechanisms underlying cerebral neuroimaging findings and to examine associations among spinal and brain magnetic resonance imaging signs. Methods We conducted a retrospective review of magnetic resonance myelography and brain magnetic resonance imaging records of patients with spontaneous intracranial hypotension. Categorical principal component analysis was employed to cluster brain neuroimaging findings. Spearman correlation was employed to analyze associations among different brain neuroimaging findings and between brain and spinal neuroimaging findings. Results In patients with spontaneous intracranial hypotension (n = 148), categorical principal component analysis of brain neuroimaging signs revealed two clusters: Cerebral venous dilation and brain descent. Among all brain magnetic resonance imaging signs examined, only midbrain-pons angle associated with anterior epidural cerebrospinal fluid collection length (surrogate spinal cerebrospinal fluid leak severity) (n = 148, Spearman’s ρ = −0.38, p < .001). Subgroup analyses showed that the association between midbrain-pons angle (within brain descent cluster) and spinal cerebrospinal fluid leak severity was presented in patients with convex margins of the transverse sinuses (n = 122, Spearman’s ρ = −0.43, p < .001), but not in patients without convex margins (n = 26, Spearman’s ρ = −0.19, p = .348). The association between severity of transverse sinus distension and spinal cerebrospinal fluid leak severity was only presented in patients without convex margins (n = 26, Spearman’s ρ = 0.52, p = .006). Conclusion This study indicates that there are two factors behind the brain neuroimaging findings in spontaneous intracranial hypotension: Cerebral venous dilation and brain descent. Certain brain neuroimaging signs correlate with spinal cerebrospinal fluid leakage severity, depending on different circumstances.

The time sequence of brain MRI findings in spontaneous intracranial hypotension

Cephalalgia ◽  
2021 ◽  
pp. 033310242110444
Author(s):  
Shu-Ting Chen ◽  
Jr-Wei Wu ◽  
Yen-Feng Wang ◽  
Jiing-Feng Lirng ◽  
Shu-Shya Hseu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intracranial Hypotension ◽  
Fluid Collection ◽  
Spontaneous Intracranial Hypotension ◽  
Brain Magnetic Resonance Imaging ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Fourth Quartile ◽  
Diffuse Pachymeningeal Enhancement

Objectives To investigate the time sequence of brain magnetic resonance imaging findings of spontaneous intracranial hypotension. Methods We retrospectively reviewed the medical records and brain magnetic resonance imaging findings of consecutive patients with spontaneous intracranial hypotension hospitalized between January 2007 and December 2017. Patients were divided into quartiles based on intervals between initial spontaneous intracranial hypotension symptom onset and brain magnetic resonance imaging scan. Six categorical and five continuous brain magnetic resonance imaging findings were assessed, including venous distension sign, enlarged pituitary gland, diffuse pachymeningeal enhancement, mid-brain pons deformity, subdural fluid collection, flattening of pons, midbrain-pons angle, descent of cerebral aqueduct, mamillopontine distance, distance of suprasellar cistern, and distance of prepontine cistern. In addition, we also calculated the neuroimaging scores with a score ≥5 classified as ‘high probability of spontaneous intracranial hypotension' and a score ≥3 as ‘intermediate-to-high probability.' Then, we analyzed the linkage between the onset-neuroimaging interval and brain magnetic resonance imaging findings, as well as different neuroimaging scores. Results A total of 173 patients (57 males and 116 females) were included in the analysis, and the range of onset-neuroimaging interval was 1 to 89 days (median [interquartile range]  =  17 [7 to 30 days]). We divided the patients into quartiles based on their onset-neuroimaging interval (the first quartile: 0–6 days; the second quartile: 7–16 days; the third quartile: 17–29 days; the fourth quartile: ≥30 days). Among brain magnetic resonance imaging findings, the incidence of venous distension sign was high (>75%), with no difference among quartiles (p = 0.876). The incidence of diffuse pachymeningeal enhancement (p = 0.001), severe midbrain-pons deformity (p = 0.001), and subdural fluid collection (<0.001) followed a significant stepwise increase from the first quartile to fourth quartile. Patients with shorter onset-neuroimaging intervals were less likely to have neuroimaging scores ≥5 (<17 vs. ≥17 days: 72.9% vs. 86.4%; odds ratio = 2.3 [95% CI 1.1–5.1], p = 0.028), but not neuroimaging scores ≥3 (<17 vs. ≥17 days: 92.9% vs. 92.0%, p = 0.824). Conclusions The emergence of brain magnetic resonance imaging findings of spontaneous intracranial hypotension depended on disease duration and appeared sequentially. When using brain magnetic resonance imaging findings or neuroimaging scores for diagnostic purposes, the onset–neuroimaging interval should be considered.

Sign in / Sign up

Export Citation Format

Share Document