Neuroimaging features of spontaneous intracranial hypotension

Neuroradiology. 2001 Aug;43(8):622-7. doi: 10.1007/s002340000529.


We reviewed the cranial MRI and radionuclide cisternograms of four adults with postural headache indicating spontaneous intracranial hypotension (SIH). All four underwent clinical and radiological follow-up. MRI showed diffuse, thin meningeal enhancement; bilateral subdural fluid collections; and morphological abnormalities secondary to "sagging" of the brain. Radionuclide cisternography revealed direct or indirect signs of leakage of cerebrospinal fluid (CSF) along the spinal axis, and the symptoms resolved after the leak treated by epidural injection of blood at a level indicated by the cisternogram. The diffuse meningeal enhancement decreased but persisted on follow-up MRI, although the patients were asymptomatic. All morphologic abnormalities resolved during 3-5 months follow-up.

MeSH terms

  • Adult
  • Blood Patch, Epidural
  • Follow-Up Studies
  • Humans
  • Intracranial Hypotension / cerebrospinal fluid
  • Intracranial Hypotension / diagnosis*
  • Intracranial Hypotension / therapy
  • Magnetic Resonance Imaging
  • Male
  • Myelography
  • Spinal Puncture