Noncontrast Brain Computed Tomography Findings of Spontaneous Intracranial Hypotension in the Emergency Department Setting

The Journal of Emergency Medicine
Daniel Yaffe, Carlos R Gordon

Abstract

Spontaneous intracranial hypotension (SIH) is a difficult diagnosis, especially in an emergency department (ED) setting where magnetic resonance imaging (MRI) is usually not available. To emphasize the presence of a very frequent but unnoticed tentorial subdural hygroma among a number of recognized noncontrast brain computed tomography (CT) findings in patients with spontaneous intracranial hypotension. This is a case series study of 7 consecutive patients with orthostatic headache who were admitted to the ED and finally diagnosed as SIH, and of 11 women who underwent brain CT due to very severe orthostatic headache after epidural anesthesia. We evaluated the CT findings of patients with SIH and further compared each patient's CT findings with their respective MRI and with the brain CT of women with postepidural anesthesia orthostatic headache. Noncontrast brain CT was abnormal in five out of seven (71%) SIH cases: tentorial subdural hygroma was found in four (57%) cases; supratentorial subdural hygroma and cervical spinal venous engorgement were found in two (29%) cases, and subdural hematoma was found in one case. All women with severe orthostatic headache after epidural anesthesia had CT findings similar to those of spontane...Continue Reading

References

Dec 17, 2003·Archives of Neurology·Wouter I Schievink
Jul 13, 2005·Neurology·Wouter I SchievinkFranklin G Moser
May 18, 2006·JAMA : the Journal of the American Medical Association·Wouter I Schievink
Oct 24, 2006·European Neurology·Elke WiesemannAnja Windhagen
Jun 19, 2013·Cephalalgia : an International Journal of Headache·UNKNOWN Headache Classification Committee of the International Headache Society (IHS)

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Citations

Mar 17, 2021·Der Schmerz·Katharina Kamm, Stefanie Förderreuther
May 29, 2021·Der Nervenarzt·Katharina Kamm, Stefanie Förderreuther

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