Type:
Educational Exhibit
Keywords:
Fistula, Cerebrospinal fluid, Treatment effects, Myelography, Diagnostic procedure, MR, CT, Neuroradiology spine, Neuroradiology brain
Authors:
C. P. Fernandez Ruiz, D. H. Jiménez, E. Garcia Martinez, L. Navarro Vilar, C. Poyatos, F. Dominguez; Valencia/ES
DOI:
10.1594/ecr2013/C-1557
Conclusion
Postural orthostatic headache is the most common symptom of HI and although this disease occurs more frequently after a lumbar puncture,
there is also a type of spontaneous onset,
caused by CSF leak,
which has even come to associate with minimum prior trauma.
Physical examination of these patients is usually normal and imaging studies are made by persistence of headache despite conventional treatment in the emergency room,
as in the case of our patients.
The initial study usually is cranial CT,
which rules out other diseases and can shows suggestive findings of IH as an increase in the subdural space by hypodense collection as most frequent finding.
The collections are thin,
unilateral or bilateral and are located on the cerebral convexity without significant mass effect.
The other signs,
obliteration of the basal cisterns and descent of the cerebellar tonsils,
should be identified to support the diagnosis.