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A Rare Case of Spinal Hypertrophic Pachymeningitis That Caused Tetraplegia After Myelography.
Cureus
December 2024
Department of Orthopaedics, Tokyo Metropolitan Bokutoh Hospital, Tokyo, JPN.
Hypertrophic pachymeningitis (HP) is a rare inflammatory disease that causes the thickening of the dura mater. Its etiology is mainly classified as idiopathic or secondary, and autoimmune disease is one of the main causes of secondary HP. Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis and IgG4-related disease are common among autoimmune diseases.
View Article and Find Full Text PDFPersistent Post-dural Puncture Headaches One Year After Lumbar Puncture: A Case Report.
Cureus
November 2024
Department of Internal Medicine, Aga Khan University Hospital, Nairobi, KEN.
Post-dural puncture headaches usually occur when the cerebrospinal fluid (CSF) leaks due to trauma to the dura mater. This often results in spontaneous intracranial hypotension characterized by orthostatic headaches, neck stiffness, and nausea. In this case report, we discuss a 20-year-old male patient who developed symptoms of intracranial hypotension one year following a lumbar puncture.
View Article and Find Full Text PDFAlternative Percutaneous Dural Puncture Routes: Cervical, Thoracic, Lumbar, and Sacral.
Neuroimaging Clin N Am
February 2025
Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University Medical Center, Center for Academic Medicine, Radiology + MC: 5659, 453 Quarry Road, Palo Alto, CA 94304, USA. Electronic address: https://twitter.com/BryanLanzman.
Patients requiring lumbar punctures (LPs) are frequently challenging or may be impossible to do through a standard lower lumbar route. Therefore, if clinically indicated, consideration of alternative anatomic access routes to the spinal subarachnoid space may be necessary. However, some of these approaches are unpopular or seldom used, may be challenging to perform, or are associated with potential significant complications especially when combined with limited operator experience.
View Article and Find Full Text PDFAssessing the Diagnostic Value of Brain White Matter Hyperintensities and Clinical Symptoms in Predicting the Detection of CSF Venous Fistula in Patients with Suspected Spontaneous Intracranial Hypotension.
AJNR Am J Neuroradiol
October 2024
From the Department of Radiology, Neuroradiology Section.
Background And Purpose: Spontaneous intracranial hypotension (SIH) due to CSF venous fistula (CVF) is increasingly recognized as a secondary cause of headaches, with symptoms often overlapping with primary headache syndromes such as migraine. While brain MRI studies have focused on features indicative of SIH, findings that support an alternate headache etiology, such as the bifrontal white matter hyperintensities (WMH) often seen in migraines, have not been explored in this context. This study assesses 1) the quantity and distribution of WMH and 2) the presenting clinical features in patients with and without CVF found on dynamic decubitus CT myelography (dCTM).
View Article and Find Full Text PDFSpontaneous Intracranial Hypotension: Role of Computed Tomography-guided Cervical Epidural Blood Patch.
J Assoc Physicians India
August 2024
Consultant, Department of Neurology, Bombay Hospital and Medical Research Center, Mumbai, Maharashtra, India.
Background: Lumbar epidural blood patch (EBP) is not successful in all cases of cerebrospinal fluid (CSF) leak, particularly in the cervicothoracic region. The present study is a retrospective analysis of a cohort of patients who had undergone computed tomography (CT)-guided cervical EBP for spontaneous intracranial hypotension (SIH) due to CSF leak in the cervical region.
Methods: We retrospectively collected data from March 2009 to 2020.
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