Frequency of spontaneous intracranial hypotension in the emergency department.

J Headache Pain

Department of Neurosurgery, The Maxine Dunitz Neurosurgical Institute, Cedars-Sinai Medical Center, 8631 West Third Street, Suite 800E, Los Angeles, CA 90048, USA.

Published: December 2007

Spontaneous intracranial hypotension is considered a rare disorder. We conducted a study on the frequency of spontaneous intracranial hypotension in the emergency department (ED). We identified patients with spontaneous intracranial hypotension evaluated in the ED of a large urban hospital between 1 January 2003 and 31 December 2006. For comparison, we also identified all patients with spontaneous subarachnoid haemorrhage (SAH). Eleven patients with previously undiagnosed spontaneous intracranial hypotension were evaluated in the ED during the four-year time period. All patients presented with positional headaches and the duration of symptoms varied from one day to three months. None of the patients were correctly diagnosed with spontaneous intracranial hypotension in the ED. During the same time period, 23 patients with aneurysmal SAH were evaluated. Spontaneous intracranial hypotension is more common than previously appreciated and the diagnosis in the ED remains problematic.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476164PMC
http://dx.doi.org/10.1007/s10194-007-0421-8DOI Listing

Publication Analysis

Top Keywords

spontaneous intracranial
28
intracranial hypotension
28
frequency spontaneous
8
hypotension emergency
8
emergency department
8
identified patients
8
patients spontaneous
8
hypotension evaluated
8
time period
8
period patients
8

Similar Publications

Azygos Vein Stenosis in Frontotemporal Dementia Sagging Brain Syndrome.

AJNR Am J Neuroradiol

January 2025

Ataxia Center, Cognitive Behavioral Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Department of Neurology (J.D.S., Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.

Background And Purpose: Symptoms indistinguishable from behavioral-variant frontotemporal dementia (bvFTD) can develop in patients with spontaneous intracranial hypotension associated with severe brain sagging. An underlying spinal CSF leak can be identified in only a minority of these patients and the success rate of nondirected treatments, such as epidural blood patching and dural reduction surgery, is low. The disability associated with bvFTD sagging brain syndrome is high and, because of the importance of the venous system in the pathophysiology of CSF leaks in general, we have investigated the systemic venous circulation in those patients with recalcitrant symptoms.

View Article and Find Full Text PDF

Background: Spinal cord vascular malformations (SCVMs) in children are relatively rare and present unique challenges due to their distinct physiological characteristics. These malformations often manifest with nonspecific clinical symptoms, increasing the likelihood of misdiagnosis. The treatment of pediatric SCVMs requires a tailored approach, with the choice between microsurgical intervention and endovascular embolization depending on the specific type of malformation and individual patient factors.

View Article and Find Full Text PDF

Background: Hematoma expansion after intracranial hemorrhage (ICH) in anticoagulated patients signifi-cantly influences clinical outcomes and mortality, emphasizing the need for effective reversal agents. Andexanet alfa is a specific reversal agent for factor Xa associated major bleeding.

Aims: The ASTRO-DE study collected real-world evidence on the effect of andexanet alfa on mitigat-ing hematoma expansion and altering prognosis in rivaroxaban- or apixaban-treated patients with ICH.

View Article and Find Full Text PDF

Background: Appropriate management of spontaneous intracerebral hemorrhage (ICH) and intraventricular hemorrhage (IVH) requires rapid, accurate volume estimation. Viz.AI has developed an artificial intelligence (AI)-powered ICH calculation tool that may improve existing methods.

View Article and Find Full Text PDF

Individualized autoregulation-guided arterial blood pressure management in neurocritical care.

Neurotherapeutics

January 2025

Division of Neurosciences Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins University School of Medicine, USA; Department of Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine, USA. Electronic address:

Cerebral autoregulation (CA) is the physiological process by which cerebral blood flow is maintained during fluctuations in arterial blood pressure (ABP). There are various validated methods to measure CA, either invasively, with intracranial pressure or brain tissue oxygenation monitors, or noninvasively, with transcranial Doppler ultrasound or near-infrared spectroscopy. Utilizing these monitors, researchers have been able to discern CA patterns in several pathological states, such as but not limited to acute ischemic stroke, spontaneous intracranial hemorrhage, aneurysmal subarachnoid hemorrhage, sepsis, and post-cardiac arrest, and they have found CA to be altered in these patients.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!