Skip to main content

Imaging Signs in Spontaneous Intracranial Hypotension: Prevalence and Relationship to CSF Pressure.

Publication ,  Journal Article
Kranz, PG; Tanpitukpongse, TP; Choudhury, KR; Amrhein, TJ; Gray, L
Published in: AJNR Am J Neuroradiol
July 2016

BACKGROUND AND PURPOSE: Patients with spontaneous intracranial hypotension often exhibit low CSF pressure and changes on brain MR imaging and/or evidence of CSF leak on myelography. We investigated whether individual imaging signs of spontaneous intracranial hypotension correlate with measured CSF pressure and how frequently these 2 markers of spontaneous intracranial hypotension were concordant. MATERIALS AND METHODS: We performed a retrospective, cross-sectional study of 99 subjects with spontaneous intracranial hypotension. Prevalence of brain and myelographic imaging signs of spontaneous intracranial hypotension was recorded. CSF pressure among subjects with or without individual imaging signs was compared by using a 2-tailed t test and ANOVA. Concordance between low CSF pressure (≤6 cm H2O) and imaging was defined as the presence of the sign in a subject with low CSF pressure or absence of the sign when pressure was not low. RESULTS: Dural enhancement, brain sagging, and venous distension sign were present in 83%, 61%, and 75% of subjects, respectively, and myelographic evidence of CSF leak was seen in 55%. Marginal correlations between CSF pressure and brain sagging (P = .046) and the venous distension sign (P = .047) were found. Dural enhancement and myelographic evidence of leak were not significantly correlated with CSF pressure. Rates of concordance between imaging signs and low CSF pressure were generally low, ranging from 39% to 55%. CONCLUSIONS: Brain and myelographic signs of spontaneous intracranial hypotension correlate poorly with CSF pressure. These findings reinforce the need to base the diagnosis of spontaneous intracranial hypotension on multiple diagnostic criteria and suggest the presence of patient-specific variables that influence CSF pressure in these individuals.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

AJNR Am J Neuroradiol

DOI

EISSN

1936-959X

Publication Date

July 2016

Volume

37

Issue

7

Start / End Page

1374 / 1378

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Prevalence
  • Nuclear Medicine & Medical Imaging
  • Neuroimaging
  • Myelography
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Intracranial Hypotension
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kranz, P. G., Tanpitukpongse, T. P., Choudhury, K. R., Amrhein, T. J., & Gray, L. (2016). Imaging Signs in Spontaneous Intracranial Hypotension: Prevalence and Relationship to CSF Pressure. AJNR Am J Neuroradiol, 37(7), 1374–1378. https://doi.org/10.3174/ajnr.A4689
Kranz, P. G., T. P. Tanpitukpongse, K. R. Choudhury, T. J. Amrhein, and L. Gray. “Imaging Signs in Spontaneous Intracranial Hypotension: Prevalence and Relationship to CSF Pressure.AJNR Am J Neuroradiol 37, no. 7 (July 2016): 1374–78. https://doi.org/10.3174/ajnr.A4689.
Kranz PG, Tanpitukpongse TP, Choudhury KR, Amrhein TJ, Gray L. Imaging Signs in Spontaneous Intracranial Hypotension: Prevalence and Relationship to CSF Pressure. AJNR Am J Neuroradiol. 2016 Jul;37(7):1374–8.
Kranz, P. G., et al. “Imaging Signs in Spontaneous Intracranial Hypotension: Prevalence and Relationship to CSF Pressure.AJNR Am J Neuroradiol, vol. 37, no. 7, July 2016, pp. 1374–78. Pubmed, doi:10.3174/ajnr.A4689.
Kranz PG, Tanpitukpongse TP, Choudhury KR, Amrhein TJ, Gray L. Imaging Signs in Spontaneous Intracranial Hypotension: Prevalence and Relationship to CSF Pressure. AJNR Am J Neuroradiol. 2016 Jul;37(7):1374–1378.

Published In

AJNR Am J Neuroradiol

DOI

EISSN

1936-959X

Publication Date

July 2016

Volume

37

Issue

7

Start / End Page

1374 / 1378

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Prevalence
  • Nuclear Medicine & Medical Imaging
  • Neuroimaging
  • Myelography
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Intracranial Hypotension
  • Humans