Spontaneous intracranial hypotension: diagnostic and therapeutic workup.
Spontaneous intracranial hypotension (SIH) is an orthostatic headache syndrome with typical MRI findings among which engorgement of the venous sinuses, pachymeningeal enhancement, and effacement of the suprasellar cistern have the highest diagnostic sensitivity. SIH is in almost all cases caused by...
| Publicado en: | Neuroradiology Vol. 63; no. 11; pp. 1765 - 1773 |
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| Autores principales: | , , , , |
| Formato: | diagnostic images review tables/charts Journal Article |
| Publicado: |
Springer Nature
Nov2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=153124025&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 153124025 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00283940 NYZ jtl: Neuroradiology issn: 00283940 maglogo: N pubinfo: dt: Nov2021 vid: 63 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 153124025 151535747 153124025 153124025 10.1007/s00234-021-02766-z 153124025 ppf: 1765 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Spontaneous intracranial hypotension: diagnostic and therapeutic workup. aug: au: Luetzen, Niklas Dovi-Akue, Philippe Fung, Christian Beck, Juergen Urbach, Horst affil: Department of Neuroradiology, Medical Center, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany sug: subj: Brain Diseases Diagnosis Hypotension Neuroradiography Cerebrospinal Fluid Vascular Fistula Magnetic Resonance Imaging Myelography Embolization, Therapeutic Intracranial Pressure ab: Spontaneous intracranial hypotension (SIH) is an orthostatic headache syndrome with typical MRI findings among which engorgement of the venous sinuses, pachymeningeal enhancement, and effacement of the suprasellar cistern have the highest diagnostic sensitivity. SIH is in almost all cases caused by spinal CSF leaks. Spinal MRI scans showing so-called spinal longitudinal extradural fluid (SLEC) are suggestive of ventral dural tears (type 1 leak) which are located with prone dynamic (digital subtraction) myelography. As around half of the ventral dural tears are located in the upper thoracic spine, additional prone dynamic CT myelography is often needed. Leaking nerve root sleeves typically associated with meningeal diverticulae (type 2 leaks) and CSF-venous fistulas (type 3 leaks) are proven via lateral decubitus dynamic digital subtraction or CT myelography: type 2 leaks are SLEC-positive if the tear is proximal and SLEC-negative if it is distal, and type 3 leaks are always SLEC-negative. Although 30–70% of SIH patients show marked improvement following epidural blood patches applied via various techniques definite cure mostly requires surgical closure of ventral dural tears and surgical ligations of leaking nerve root sleeves associated with meningeal diverticulae or CSF-venous fistulas. For the latter, transvenous embolization with liquid embolic agents via the azygos vein system is a novel and valuable therapeutic alternative. pubtype: Academic Journal doctype: diagnostic images review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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