Spontaneous intracranial hypotension

• Published in: Practical neurology Vol. 24; no. 2; pp. 98 - 105
• Main Authors: Cheema, Sanjay, Mehta, Dwij, Qureshi, Ayman, Sayal, Parag, Kamourieh, Salwa, Davagnanam, Indran, Matharu, Manjit
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.04.2024; BMJ Publishing Group LTD
• Subjects: Back pain; Cardiac arrhythmia; Cerebrospinal Fluid Leak - complications; CSF; CSF DYNAMICS; Epidural; HEADACHE; Headache - diagnostic imaging; Headache - etiology; Headaches; Humans; Hypotension; Intracranial Hypotension - diagnosis; Intracranial Hypotension - diagnostic imaging; Magnetic Resonance Imaging - adverse effects; Medical diagnosis; Migraine; Nausea; Neck pain; NEURORADIOLOGY; Patients; Posture; Review; Thrombosis; Tinnitus; Vertigo; United Kingdom > UK; NEURORADIOLOGY; HEADACHE; CSF DYNAMICS; CSF
• ISSN: 1474-7758; 1474-7766
• DOI: 10.1136/pn-2023-003986

Spontaneous intracranial hypotension (SIH) is a highly disabling but treatable secondary cause of headache. Recent progress in neuroradiological techniques has catalysed understanding of its pathophysiological basis and clinical diagnosis, and facilitated the development of more effective investigation and treatment methods. A UK-based specialist interest group recently produced the first multidisciplinary consensus guideline for the diagnosis and treatment of SIH. Here, we summarise a practical approach to its clinical and radiological diagnosis, symptomatic and non-targeted interventional treatment, radiological identification of leak site and targeted treatment of the leak once it has been localised.