Diagnosis and Treatment of Spontaneous Intracranial Hypotension
Andrew L. Callen, Deborah I. Friedman, Simy Parikh, Jill C. Rau, Wouter I. Schievink, Jeremy K. Cutsforth‐Gregory, Timothy J. Amrhein, Elena S. Haight, Robert P. Cowan, Meredith Barad, Jennifer M. Hah, T.A. Jackson, Connie Deline, A. Buchanan, Ian Carroll
Abstract
Purpose of Review: This review focuses on the challenges of diagnosing and treating spontaneous intracranial hypotension (SIH), a condition caused by spinal CSF leakage. It emphasizes the need for increased awareness and advocates for early and thoughtful use of empirical epidural blood patches (EBPs) in suspected cases. Recent Findings: SIH diagnosis is hindered by variable symptoms and inconsistent imaging results, including normal brain MRI and unreliable spinal opening pressures. It is crucial to consider SIH in differential diagnoses, especially in patients with connective tissue disorders. Early EBP intervention is shown to improve outcomes. Summary: SIH remains underdiagnosed and undertreated, requiring heightened awareness and understanding. This review promotes proactive EBP use in managing suspected SIH and calls for continued research to advance diagnostic and treatment methods, emphasizing the need for innovative imaging techniques for accurate diagnosis and timely intervention.