Article Figures & Data
Figures
- Fig 1.
Postmyelography CTs showing (A) bilateral cervicothoracic CSF leaks without an associated meningeal diverticulum; B, Left thoracic meningeal diverticulum with an associated CSF leak; and C, right thoracic meningeal diverticulum without an associated CSF leak.
- Fig 2.
A, Brain MR images showing typical findings in spontaneous intracranial hypotension with a coronal T2-weighted image showing subdural fluid collections; B, a coronal gadolinium-enhanced T1-weighted image showing enhancement of the pachymeninges; and C, a T1-weighted sagittal image showing sagging of the brain.
Tables
Criterion A, demonstration of a spinal CSF leak (ie, presence of extrathecal CSF), or, if criterion A not met: Criterion B, cranial MR imaging changes of intracranial hypotension (ie, presence of subdural fluid collections, enhancement of the pachymeninges, or sagging of the brain), and the presence of at least one of the following: low opening pressure (≤60 mm H2O);
spinal meningeal diverticulum;
improvement of symptoms after epidural blood patching;
or, if criteria A and B not met: Criterion C, the presence of all of the following or at least 2 of the following if typical orthostatic headaches are present: low opening pressure (≤60 mm H2O),
spinal meningeal diverticulum, and
improvement of symptoms after epidural blood patching.
Note:—Patients with onset of symptoms after dural puncture or other penetrating spinal trauma are excluded.
- Table 2:
Data on 107 patients evaluated for spontaneous spinal CSF leak and intracranial hypotension
Criterion Total No. M:F Mean Age (SD) Range Positive Brain MR Results Spinal Imaging CSF Leak/Diverticula Low OP Response to EBP Patients meeting diagnostic criteria Criterion A 78 40.6 (12.5) 30:48 12–61 57/78 78/28 60/64 72/75 Criterion B 11 49.2 (12.3) 11/11 0/7 5/6 7/8 4:7 34–72 Criterion C 5 42.8 (6.6) 0/5 0/5 5/5 5/5 2:3 37–52 Total 94 41.7 (12.5) 68/94 78/40 70/75 84/88 36:58 12–72 Patients not meeting diagnostic criteria 13 43.5 (20.3) 0/13 0/0 1/13 1/11 4:9 13–76 Note:—M:F indicates male-to-female ratio; SD, standard deviation; OP, opening pressure; EBP, epidural blood patch.
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