ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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2018
vol. 83
 
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abstract:
Case report

Spontaneous intracranial hypotension: two steroid-responsive cases

Russo Camilla, Buono Vincenzo, Fenza Giacomo, Zandolino Alexis, Serino Antonietta, Manto Andrea

© Pol J Radiol 2018; 83: e229-e233
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Purpose
Spontaneous intracranial hypotension (SIH) is characterised by orthostatic headache, low cerebrospinal fluid pressure and diffuse pachymeningeal enhancement after intravenous gadolinium contrast administration. Magnetic resonance imaging (MRI) often plays a crucial role for correct diagnosis.

Case description
We described two similar cases of SIH, whose clinical and imaging features are typical for this pathology. At MRI brain scan, both patients showed diffuse and intense pachymeningeal enhancement and moderate venous distension and epidural vein engorgement. The two patients were treated with bed rest and oral steroid therapy, with complete and long-lasting symptomatic relief.

Conclusions
Orthostatic nature of headache is the most indicative clinical feature suggesting SIH; contrast-enhanced MRI provides definite imaging diagnostic findings. Conservative treatment coupled to steroid therapy is often sufficient to obtain complete disappearance of symptoms.

keywords:

spontaneous intracranial hypotension (SIH), cerebrospinal fluid (CSF) pressure, myelopathy

 
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