The purpose of this poster is to review the syndrome of Intracranic Hypotension (IH) through three steps: Step 1- introducing pathophysiology and imaging featuresof Intracranial Hypotension (IH): from Monro-Kellie hypothesis to MRI signs; Step 2- discussing the possible differential diagnosis of IH; Step 3- investigating CSF leakage with different imaging modalities and discuss some treatment options.
Intracranial hypotension is a condition of subnormal pressure levels within the brain cavity due to CSF volume depletion and resultant low CSF hydrostatic pressure.
The ultimate cause is always a “duropathy”,
a dural disorder,
either in the form of en evident breach or as a subtle dural weakness without an exact leakage site.
It can occur spontaneously or secondary to lumbar puncture,
surgery or traumatic events ( Fig 1,
Orthostatic headache is the most common clinical symptom that...
Findings and procedure details
The starting point in the diagnosis of HI is an MRI study of the brain to look for the most pathognomonic signs (subdural fluid collections,
sagging of midbrain and pachymeningeal enhancement) and other associated findings that can confirm the clinical hypothesis. More than two centuries ago,
Alexander Monro applied some of the principles of physics to the intracranial contents and hypothesized that the intracranial blood circulation was of constant volume at all times.
This hypothesis was...
Diagnosis of IH has always been more clinical than radiological.
However MRI has revolutionized our understanding of this condition.
In this review we illustrate how necessary is to integrate both clinical and neuroradiological features in order to make a correct diagnosis and avoid rare but serious complications.
Pandey. Large-Volume Blood Patch to Multiple Sites in the Epidural Space through a Single-Catheter Access Site for Treatment of Spontaneous Intracranial Hypotension .
AJNR Am J Neuroradiol 35:1841-46 Sep 2014. 2- Nadir Ali Syed,
Farhan Arshad Mirza,
Aqueel Hussain Pabaney,
Rameez-ul-Hassan. Pathophysiology and management of Spontaneous Intracranial Hypotension — A Review. J Pak Med Assoc,
January 2012. 3- W.I....