We applied the recent International Headache Society (IHS) criteria for headache related to spontaneous intracranial hypotension (SIH) to 90 consecutive patients with a final diagnosis of SIH confirmed by cerebral magnetic resonance imaging with contrast. Orthostatic headache (developing within 2 h of standing or sitting up) was present in 67 patients (75%) but appeared within 15 min after stan...

A 51-year-old woman presented with a rare case of spontaneous intracranial hypotension (SIH) complicated by a delayed subdural hematoma (SDH) that required surgical evacuation 2 months after epidural blood patching (EBP). Subdural fluid collections are common among patients with SIH. These fluid collections vary in appearance from thin subdural hygromas to rare large SDHs associated with signif...

CSF-venous fistula is a recently reported cause of spontaneous intracranial hypotension that may occur in the absence of myelographic evidence of CSF leak. Information about this entity is currently very limited, but it is of potential importance given the large percentage of cases of spontaneous intracranial hypotension associated with negative myelography findings. We report 3 additional case...

We report the use of an emergent, targeted fibrin spinal epidural blood patch with subarachnoid saline infusion to rapidly reverse "in-extremis" clinical and imaging signs of posterior-fossa coning brought about by acute-on-chronic intracranial hypotension, itself consequent to a cervicothoracic CSF leak. Treatment resulted in a dramatic recovery and eventual discharge with return to normal lif...

A 37-year-old woman presented with acute orthostatic hypotension and diffuse headache. Brain magnetic resonance imaging (MRI) revealed T2 hyperintense bilateral subdural effusions, diffuse pachymeningeal enhancement, slit ventricles and venous engorgement compatible with spontaneous intracranial hypotension. Single photon emission computed tomography with computed tomography (CT) and CT-cistern...

manipulation, usually administered in the course of chiropractic treatment, can cause stroke, 10 and abducens paresis may develop if there is brainstem infarction or neck vessel dissection. Since our patient had no signs of brainstem infarction and her neck vessels appeared pristine on MRI, her abducens paresis undoubtedly resulted from the intracranial hypotension per se. Ophthalmologists eval...

Intracranial hypotension is typically manifested by orthostatic headache. The most frequent underlying factor is cerebrospinal fluid leakage. It has been suggested that dural structural weakness in some connective tissue diseases may be responsible for dural tears and diverticula and consequently leakage. We present a case of spontaneous intracranial hypotension associated with Marfan syndrome ...