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Update on the Diagnosis and Treatment of Spontaneous Intracranial Hypotension

  • Migraine and Beyond (R Cowan, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this study is to provide an update on recent developments in the understanding, diagnosis, and treatment of spontaneous intracranial hypotension (SIH).

Recent Findings

SIH is an important cause of headaches caused by spinal cerebrospinal fluid (CSF) leaks, with an increasingly broad spectrum of clinical presentations and diagnostic findings. A simple conception of the condition as being defined by the presence of low CSF pressure is no longer sufficient or accurate. A number of etiologies for spinal CSF leaks have been identified, including the recent discovery of CSF-venous fistulas, and these various etiologies may require different diagnostic and therapeutic pathways in order to affect a cure.

Summary

Familiarity with the spectrum of presentations and causes of SIH is critical to accurate and timely diagnosis and management. Challenges exist in both diagnosis and treatment, and require understanding of the underlying pathogenesis of the condition in order to appropriately select testing and treatment. Prospective studies are needed going forward in order to inform workup and guide treatment decisions.

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Authors and Affiliations

  1. Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC, 27710, USA

    Peter G. Kranz, Michael D. Malinzak, Timothy J. Amrhein & Linda Gray

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  1. Peter G. Kranz
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  2. Michael D. Malinzak
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  3. Timothy J. Amrhein
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  4. Linda Gray
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Correspondence to Peter G. Kranz.

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Peter G. Kranz, Michael D. Malinzak, Timothy J. Amrhein, and Linda Gray each declare no potential conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Migraine and Beyond

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Kranz, P.G., Malinzak, M.D., Amrhein, T.J. et al. Update on the Diagnosis and Treatment of Spontaneous Intracranial Hypotension. Curr Pain Headache Rep 21, 37 (2017). https://doi.org/10.1007/s11916-017-0639-3

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