Spontaneous Intracranial Hypotension: Pathogenesis, Diagnosis, and Treatment

Abstract

Spontaneous intracranial hypotension (SIH) is a clinical syndrome that is increasingly recognized as an important and treatable secondary cause of headaches. Insight into the condition has evolved significantly over the past decade, resulting in a greater understanding of the underlying pathophysiology, development of new diagnostic imaging tools, and a broadening array of targeted treatment options. This article reviews the clinical presentation and pathogenesis of SIH, discusses the important role of imaging in diagnosis, and describes how imaging guides treatment.

Keywords: CSF leak; CSF-venous fistula; Epidural blood patch; Myelography; Spontaneous intracranial hypotension.