Spontaneous intracranial hypotension (SIH) is an uncommon condition characterised by postural headache secondary to low cerebrospinal fluid pressure. Here we present a case of recurrence of SIH in early pregnancy in a 26-year-old woman. She first presented at the age of 21 years at 15 weeks' gestation with a history of headache, nausea, vomiting, neck stiffness and photophobia. Findings from a MRI brain scan led to a diagnosis of SIH. She was treated with autologous epidural blood patching and remained asymptomatic until her second pregnancy 5 years later, when she re-presented at 16 weeks' gestation with similar symptoms. She was again diagnosed with SIH and required a repeat treatment of autologous epidural blood patching. She subsequently remained symptom free and delivered a healthy boy at term.
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http://dx.doi.org/10.1136/bcr.05.2010.3040 | DOI Listing |
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 PDFFront Surg
January 2025
Department of Breast Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
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 PDFInt J Stroke
January 2025
Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany.
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.
J Neurointerv Surg
January 2025
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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 PDFNeurotherapeutics
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.
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