+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Lack of causal association between spontaneous intracranial hypotension and cranial cerebrospinal fluid leaks



Lack of causal association between spontaneous intracranial hypotension and cranial cerebrospinal fluid leaks



Journal of Neurosurgery 116(4): 749-754



Spontaneous intracranial hypotension is an important cause of headaches and an underlying spinal CSF leak can be demonstrated in most patients. Whether CSF leaks at the level of the skull base can cause spontaneous intracranial hypotension remains a matter of controversy. The authors' aim was to examine the frequency of skull base CSF leaks as the cause of spontaneous intracranial hypotension. Demographic, clinical, and radiological data were collected from a consecutive group of patients evaluated for spontaneous intracranial hypotension during a 9-year period. Among 273 patients who met the diagnostic criteria for spontaneous intracranial hypotension and 42 who did not, not a single instance of CSF leak at the skull base was encountered. Clear nasal drainage was reported by 41 patients, but a diagnosis of CSF rhinorrhea could not be established. Four patients underwent exploratory surgery for presumed CSF rhinorrhea. In addition, the authors treated 3 patients who had a postoperative CSF leak at the skull base following the resection of a cerebellopontine angle tumor and developed orthostatic headaches; spinal imaging, however, demonstrated the presence of a spinal source of CSF leakage in all 3 patients. There is no evidence for an association between spontaneous intracranial hypotension and CSF leaks at the level of the skull base. Moreover, the authors' study suggests that a spinal source for CSF leakage should even be suspected in patients with orthostatic headaches who have a documented skull base CSF leak.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 054062734

Download citation: RISBibTeXText

PMID: 22264184

DOI: 10.3171/2011.12.jns111474


Related references

Chronic cerebellar hemorrhage in spontaneous intracranial hypotension: association with ventral spinal cerebrospinal fluid leaks: clinical article. Journal of Neurosurgery. Spine 15(4): 433-440, 2011

Spontaneous cerebrospinal fluid leaks: from intracranial hypotension to cerebrospinal fluid hypovolemia--evolution of a concept. Mayo Clinic Proceedings 74(11): 1113-1123, 1999

Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. JAMA 295(19): 2286-2296, 2006

Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. Journal of Neurosurgery 84(4): 598-605, 1996

Upright MRI in spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. Headache 47(9): 1345-1346, 2007

Intracranial hypotension secondary to spontaneous spinal cerebrospinal fluid leaks. Arquivos de Neuro-Psiquiatria 75(3): 201-202, 2017

Cryptogenic Cerebrospinal Fluid Leaks in Spontaneous Intracranial Hypotension: Role of Dynamic CT Myelography. Radiology 289(3): 766-772, 2018

Recurrent spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension: a prospective study. Journal of Neurosurgery 99(5): 840-842, 2003

Spontaneous nerve root cerebrospinal fluid leaks and intracranial hypotension: case report. Arquivos de Neuro-Psiquiatria 61(1): 134-136, 2003

The role of computerized tomography-myelography in a patient with spontaneous intracranial hypotension from multiple cerebrospinal fluid leaks. Clinical Journal of Pain 22(9): 831-833, 2006

Connective Tissue Disorders with Spontaneous Spinal Cerebrospinal Fluid Leaks and Intracranial Hypotension: A Prospective Study. Neurosurgery 54(1): 65-71, 2004

Connective tissue disorders with spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension: a prospective study. Neurosurgery 54(1): 65-70; Discussion 70-1, 2004

Intrathecal preservative-free normal saline challenge magnetic resonance myelography for the identification of cerebrospinal fluid leaks in spontaneous intracranial hypotension. Journal of Neurosurgery 123(3): 732-736, 2015

Case report: spontaneous intracranial hypotension in association with the presence of a false localizing C1-C2 cerebrospinal fluid leak. Surgical Neurology 70(5): 539, 2008

Treatment strategy for cerebral hypotension caused by spontaneous cerebrospinal fluid leaks. Acta Neurochirurgica 158(2): 273-278, 2016