Intracranial hypotension syndrome: A post dural puncture headache?
Keywords:
Epidural anesthesia, Spinal anesthesia, Cerebrum, Anesthesia
Abstract
The intracranial hypotension syndrome (IHS) is a disorder caused by brain descent due to a CSF leak resulting from diagnostic, therapeutic or spontaneous lesions. The pathophysiology, the clinical and the therapeutic approach are similar as in post dural puncture headache, the latter being considered a mild form of IHS. This paper describes two patients with orthostatic headache and severe neurological involvement after epidural and spinal anesthesia, diagnosed and treated as post dural puncture headache, but who required additional care because of their abnormal course. IHS is a serious complication that may result in clinical decline and death; consequently, it requires a comprehensive approach to the various triggering factors, the clinical picture, diagnostic methods, pathophysiology and management.
References
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2. Albayram S, Wasserman BA, Yousem DM, Wityk R. Intracranial hypotension as a cause of radiculopathy from cervical epidural venous engorgement: case report. AJNR Am J Neuroradiol. 2002;23:618-21.
3. Paldino M, Mogilner AY, Tenner MS. Intracranial hypotension syndrome: a comprehensive review. Neurosurg Focus. 2003;15:ECP2.
4. Chiapparini L, Ciceri E, Nappini S, Castellani MR, Mea E, Bussone G, et al. Headache and intracranial hypotension: neuroradiological findings. Neurol Sci. 2004;25 Suppl 3:S138-41.
5. Reina MA, Alvarez-Linera J, López A, Benito-León J, De-Andrés JA, Sola RG. Magnetic resonance in dural post-puncture-headache in patient with cerebrospinal fluid hypotension. Rev Esp Anestesiol Reanim. 2002;49:89-100.
6. Watanabe A, Horikoshi T, Uchida M, Koizumi H, Yagishita T, Kinouchi H. Diagnostic value of spinal-MR-imaging in spontaneous intracranial hypotension syndrome. AJNR Am J Neuroradiol. 2009;30:147-51.
7. Barahona ML, Mora-Encinas JP, Gonzalez-Montano VM, Pozo-Zamorano T, Fernandez-Gil MA. Intracranial hypotension syndrome: review of magnetic resonance. Rev Neurol. 2011;52:676-80.
8. Grant R, Condon B, Hart I, Teasdale GM. Changes in intracranial CSF volume after lumbar puncture and their relationship to-post-LP-headache. J Neurol Neurosurg Psychiatry. 1991;54:440-2.
9. Ferrante E, Savino A, Sances G, Nappi G. Spontaneous intracranial hypotension syndrome: report of twelve cases. Headache. 2004;44:615-22.
10. O'Brien M, O'Keeffe D, Hutchinson M, Tubridy N. Spontaneous intracranial hypotension: case reports and literature review. Ir J Med Sci. 2012;181:171-7.
11. Miyazawa K, Shiga Y, Hasegawa T, Endoh M, Okita N, Higano S, et al. CSF hypovolemia vs intracranial hypotension in «spontaneous intracranial hypotension syndrome». Neurology. 2003;60:941-7.
12. Grände PO. Mechanisms behind postspinal headache and brain stem compression following lumbar dural puncture-a physiological approach. Acta Anaesthesiol Scand. 2005;49:619-26.
13. Grimaldi D, Mea E, Chiapparini L, Ciceri E, Nappini S, Savoiardo M. Spontaneous low cerebrospinal pressure: a mini review. Neurol Sci. 2004;25 Suppl 3:S135-7.
14. Schick U, Musahl C, Papke K. Diagnostics and treatment of spontaneous intracranial hypotension. Minim Invasive Neurosurg. 2010;53:15-20.
15. Ramesha KN, Chandrashekaran K, Thomas SV. Cerebrospinal fluid hypovolemia syndrome with benign course. Ann Indian Acad Neurol. 2010;13:293-6.
16. Gentile S, Giudice RL, Martino PD, Rainero I, Pinessi L. Headache attributed to spontaneous low CSF pressure: report of three cases responsive to corticosteroids. Eur J Neurol. 2004;11:849-51.
17. Diaz JH. Epidemiology and outcome of postural headache management in spontaneous intracranial hypotension. Reg Anesth Pain Med. 2001;26:582-7.
18. Levine DN, Rapalino O. The pathophysiology of lumbar puncture headache. J Neurol Sci. 2001;192: 1-8.
19. Peng PW. Intracranial hypotension with severe neurological symptoms resolved by epidural blood patch. Can J Neurol Sci. 2004;31:569-71.
2. Albayram S, Wasserman BA, Yousem DM, Wityk R. Intracranial hypotension as a cause of radiculopathy from cervical epidural venous engorgement: case report. AJNR Am J Neuroradiol. 2002;23:618-21.
3. Paldino M, Mogilner AY, Tenner MS. Intracranial hypotension syndrome: a comprehensive review. Neurosurg Focus. 2003;15:ECP2.
4. Chiapparini L, Ciceri E, Nappini S, Castellani MR, Mea E, Bussone G, et al. Headache and intracranial hypotension: neuroradiological findings. Neurol Sci. 2004;25 Suppl 3:S138-41.
5. Reina MA, Alvarez-Linera J, López A, Benito-León J, De-Andrés JA, Sola RG. Magnetic resonance in dural post-puncture-headache in patient with cerebrospinal fluid hypotension. Rev Esp Anestesiol Reanim. 2002;49:89-100.
6. Watanabe A, Horikoshi T, Uchida M, Koizumi H, Yagishita T, Kinouchi H. Diagnostic value of spinal-MR-imaging in spontaneous intracranial hypotension syndrome. AJNR Am J Neuroradiol. 2009;30:147-51.
7. Barahona ML, Mora-Encinas JP, Gonzalez-Montano VM, Pozo-Zamorano T, Fernandez-Gil MA. Intracranial hypotension syndrome: review of magnetic resonance. Rev Neurol. 2011;52:676-80.
8. Grant R, Condon B, Hart I, Teasdale GM. Changes in intracranial CSF volume after lumbar puncture and their relationship to-post-LP-headache. J Neurol Neurosurg Psychiatry. 1991;54:440-2.
9. Ferrante E, Savino A, Sances G, Nappi G. Spontaneous intracranial hypotension syndrome: report of twelve cases. Headache. 2004;44:615-22.
10. O'Brien M, O'Keeffe D, Hutchinson M, Tubridy N. Spontaneous intracranial hypotension: case reports and literature review. Ir J Med Sci. 2012;181:171-7.
11. Miyazawa K, Shiga Y, Hasegawa T, Endoh M, Okita N, Higano S, et al. CSF hypovolemia vs intracranial hypotension in «spontaneous intracranial hypotension syndrome». Neurology. 2003;60:941-7.
12. Grände PO. Mechanisms behind postspinal headache and brain stem compression following lumbar dural puncture-a physiological approach. Acta Anaesthesiol Scand. 2005;49:619-26.
13. Grimaldi D, Mea E, Chiapparini L, Ciceri E, Nappini S, Savoiardo M. Spontaneous low cerebrospinal pressure: a mini review. Neurol Sci. 2004;25 Suppl 3:S135-7.
14. Schick U, Musahl C, Papke K. Diagnostics and treatment of spontaneous intracranial hypotension. Minim Invasive Neurosurg. 2010;53:15-20.
15. Ramesha KN, Chandrashekaran K, Thomas SV. Cerebrospinal fluid hypovolemia syndrome with benign course. Ann Indian Acad Neurol. 2010;13:293-6.
16. Gentile S, Giudice RL, Martino PD, Rainero I, Pinessi L. Headache attributed to spontaneous low CSF pressure: report of three cases responsive to corticosteroids. Eur J Neurol. 2004;11:849-51.
17. Diaz JH. Epidemiology and outcome of postural headache management in spontaneous intracranial hypotension. Reg Anesth Pain Med. 2001;26:582-7.
18. Levine DN, Rapalino O. The pathophysiology of lumbar puncture headache. J Neurol Sci. 2001;192: 1-8.
19. Peng PW. Intracranial hypotension with severe neurological symptoms resolved by epidural blood patch. Can J Neurol Sci. 2004;31:569-71.
How to Cite
1.
Quintero IF, Candamil Ángela, Mejía Mantilla JH, Medina H, Ariza Cadena F. Intracranial hypotension syndrome: A post dural puncture headache?. Colomb. J. Anesthesiol. [Internet]. 2013 Jan. 1 [cited 2024 May 5];41(1):57-60. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/558
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Published
2013-01-01
How to Cite
1.
Quintero IF, Candamil Ángela, Mejía Mantilla JH, Medina H, Ariza Cadena F. Intracranial hypotension syndrome: A post dural puncture headache?. Colomb. J. Anesthesiol. [Internet]. 2013 Jan. 1 [cited 2024 May 5];41(1):57-60. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/558
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Section
Case Report / Case Series
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