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Popping the balloon: Abrupt onset of a spinal CSF leak and spontaneous intracranial hypotension in idiopathic intracranial hypertension, a case report.

Publication ,  Journal Article
Sulioti, G; Gray, L; Amrhein, TJ
Published in: Headache
February 2022

OBJECTIVES: Spontaneous intracranial hypotension (SIH) is a debilitating neurologic condition that is often thought of as separate from idiopathic intracranial hypertension (IIH). The unique case presented here details a spontaneous spinal cerebrospinal fluid (CSF) leak that developed abruptly following a CSF pressure elevating maneuver in a patient with pre-existing intracranial hypertension, raising the possibility of a causative link between the two conditions. RESULTS: A 40-year-old woman with symptomatic IIH developed a dural tear of a thoracic spinal nerve root sleeve during an episode of Valsalva maneuver leading to a CSF leak and development of symptomatic SIH. This was successfully treated with epidural blood and fibrin glue patch and the patient is now symptom-free. DISCUSSION: The implication of a possible causative link between elevated CSF pressure and subsequent development of dural rupture and SIH raises important questions regarding the pathophysiology of SIH in some cases. Furthermore, it suggests that there could be a potential prophylactic benefit of CSF pressure lowering medications in preventing the development of SIH in patients with IIH.

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Published In

Headache

DOI

EISSN

1526-4610

Publication Date

February 2022

Volume

62

Issue

2

Start / End Page

208 / 211

Location

United States

Related Subject Headings

  • Pseudotumor Cerebri
  • Neurology & Neurosurgery
  • Magnetic Resonance Imaging
  • Intracranial Hypotension
  • Intracranial Hypertension
  • Humans
  • Female
  • Cerebrospinal Fluid Pressure
  • Cerebrospinal Fluid Leak
  • Blood Patch, Epidural
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Journal cover image

Published In

Headache

DOI

EISSN

1526-4610

Publication Date

February 2022

Volume

62

Issue

2

Start / End Page

208 / 211

Location

United States

Related Subject Headings

  • Pseudotumor Cerebri
  • Neurology & Neurosurgery
  • Magnetic Resonance Imaging
  • Intracranial Hypotension
  • Intracranial Hypertension
  • Humans
  • Female
  • Cerebrospinal Fluid Pressure
  • Cerebrospinal Fluid Leak
  • Blood Patch, Epidural