Purpose Of Review: Spontaneous intracranial hypotension (SIH) is a debilitating disease typically featuring orthostatic headache and caused by a spinal CSF leak. This review will describe the characteristics of SIH in pregnant patients and the associated unique management and treatment considerations.
Recent Findings: Herein, a novel case is reported of a 41-year-old woman who presented with SIH pre-conception but saw marked improvement of symptoms after 5 weeks antepartum and symptom recurrence 2 months post-partum. A literature review of SIH in pregnancy revealed 14 reported patients across 10 studies since 2000. All the reported cases resulted in delivery of healthy infants and symptomatic improvement with conservative management or a variety of treatment modalities including non-targeted epidural blood patch (EBP). Clinical and imaging features of SIH in pregnancy are reviewed. We hypothesize an antenatal protective mechanism against SIH symptoms through cephalad redistribution of CSF volume from the spinal to intracranial compartments related to uterine growth and decreased CSF volume within the lumbar cistern. Treatment recommendations are discussed including duration of bed rest and decision for non-targeted multi-site EBPs. When required, non-invasive diagnostic spine MRI using fat-suppressed axial T2-weighted imaging may be helpful.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s11916-023-01163-w | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical presentation, diagnostic investigations and follow-up of a Bengal tiger ( affected by ambulatory tetraparesis.
Braz J Vet Med
January 2025
Veterinarian, Neurology Department, AniCura Istituto Veterinario di Novara, Granozzo con Monticello, Novara, Italy.
An 11-year-old male Bengal tiger () was referred for a 2-week history of ambulatory tetraparesis, generalized ataxia, and hypermetric gait, associated with mild right head tilt and spontaneous proprioceptive deficit on the right forelimb. Neuroanatomical localization was C1-C5 myelopathy; cerebellum-vestibular system involvement was also considered. Hematology and serum biochemistry were unremarkable, although serum vitamin A (0.
View Article and Find Full Text PDFComparison of Outcomes of Hinge Craniotomy Versus Decompressive Craniectomy in Patients With Malignant Intracranial Hypertension: A Prospective, Randomized Controlled Study.
Korean J Neurotrauma
December 2024
Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Objective: This randomized controlled trial (RCT) aimed to compare the short-, mid-, and long-term outcomes in patients with malignant intracranial hypertension undergoing either decompressive craniectomy (DC) or hinge craniotomy (HC).
Methods: In this prospective RCT, 38 patients diagnosed with malignant intracranial hypertension due to ischemic infarction, traumatic brain injury, or non-lesional spontaneous intracerebral hemorrhage, who required cranial decompression, were randomly allocated to the DC and HC groups.
Results: The need for reoperation, particularly cranioplasty, in the DC group was significantly different from that in the HC group.
Prenatally diagnosed intracranial hemorrhage in the fetus is associated with a wide range of neonatal disorders, from completely uncomplicated physiological development to severe neurological impairment or death. The incidence is 0.6-1/1,000 births.
View Article and Find Full Text PDFPrevalence and characteristics of microspurs in patients with spontaneous intracranial hypotension compared to the general population.
AJNR Am J Neuroradiol
January 2025
From the Department of Neurosurgery (D.N., L.H., J.G., T.P., R.T.S., A.R., C.M.J.); Department of Neuroradiology (T.D., E.I.P.), Institute of Diagnostic and Interventional Neuroradiology, and Department of Neurology (C.S.), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Department of Neurosurgery (J.B.), Medical Center, University of Freiburg, Freiburg, Germany.
Background And Purpose: In patients diagnosed with spontaneous intracranial hypotension (SIH), microspurs are considered the culprit lesion in most ventral dural leaks (type I). The imaging characteristics of discogenic spurs, and their prevalence in the general population has not been reported in the literature.
Materials And Methods: This observational case-control study was conducted comparing the prevalence and characteristics of discogenic microspurs between SIH patients with a type I leak treated at a tertiary hospital between 2013 and 2023 and an age-and sex matched cohort of trauma patients.
A common data model for oral anticoagulants-related risk of spontaneous intracranial hemorrhage.
J Clin Neurosci
January 2025
Deparment of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro Jongno-gu, Seoul 03080, Republic of Korea. Electronic address:
Spontaneous intracranial hemorrhage (sICH) is a major complication associated with oral anticoagulation which results in a high mortality rate, and the incidence of anticoagulant-induced sICH has increased markedly, so it is necessary to investigate the risk of anticoagulation-related sICH in a real-world setting. We aimed to investigate the incidence and risk factors of oral anticoagulant-related sICH using a common data model (CDM), and to determine whether a clinical study using the CDM would be comparable to conventional studies. After converting the various clinical codes of 12,821 patients taking oral anticoagulants, such as warfarin and non-vitamin K antagonist oral anticoagulants (NOACs), into the Observational Medical Outcomes Partnership (OMOP) CDM format, we analyzed the incidence and risk factors of sICH.
View Article and Find Full Text PDFWant 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!