AI Article Synopsis
- The study aimed to explore the various symptoms of spontaneous intracranial hypotension (SIH) beyond its hallmark symptom, orthostatic headache, to aid in better diagnosis for clinicians.
- Out of 112 patients diagnosed with SIH, 79 participated, with 84.8% reporting initial orthostatic headaches while 15.2% did not; nearly all experienced additional symptoms such as cephalic pressure, neck pain, and auditory disturbances.
- The findings emphasize that many patients present without orthostatic headaches and that SIH symptoms can develop non-linearly, highlighting the need for clinicians to maintain a high suspicion for early diagnosis and treatment.
Article Abstract
Objective: Although orthostatic headache is the hallmark symptom of spontaneous intracranial hypotension (SIH), patients can present with a wide range of different complaints and thereby pose a diagnostic challenge for clinicians. Our aim was to describe and group the different symptoms associated with SIH and their course over time.
Methods: We retrospectively surveyed consecutive patients diagnosed and treated for SIH at our institution from January 2013 to May 2020 with a specifically designed questionnaire to find out about their symptomatology and its course.
Results: Of 112 eligible patients, 79 (70.5%) returned the questionnaire and were included in the analysis. Of those, 67 (84.8%) reported initial orthostatic headaches, whereas 12 (15.2%) denied having this initial symptom. All except one (98.7%) patients reported additional symptoms: most frequently cephalic pressure (69.6%), neck pain (68.4%), auditory disturbances (59.5%), nausea (57%), visual disturbances (40.5%), gait disturbance (20.3%), confusion (10.1%) or sensorimotor deficits (21.5%). Fifty-seven (72.2%) patients reported a development of the initial symptoms predominantly in the first three months after symptom onset. Age and sex were not associated with the symptomatology or its course (p > 0.1).
Conclusion: Although characteristic of SIH, a relevant amount of patients present without orthostatic headaches. In addition, SIH can manifest with non-orthostatic headaches at disease onset or during the course of the disease. Most patients report a wide range of associated complaints. A high degree of suspicion is crucial for an early diagnosis and targeted treatment.
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| http://dx.doi.org/10.1016/j.clineuro.2023.108087 | DOI Listing |
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