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  1. Spontaneous intracranial hypotension.: An article from: Southern Medical Journal by Megdad Zaatreh, Alan Finkel, 2002-11-01

21. Blackwell Synergy - Cookie Absent
intracranial hypotension Aggravation of Headache at High Altitude Spontaneous intracranial hypotension is an increasingly recognized disorder, often,
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1526-4610.2005.05077_2.x
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22. Spontaneous Intracranial Hypotension: Report Of Two Cases And Review Of The Lite
We report two patients with spontaneous intracranial hypotension. Cerebral Angiographic Findings of Spontaneous intracranial hypotension
http://www.neurology.org/cgi/content/abstract/42/3/481
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Spontaneous intracranial hypotension: report of two cases and review of the literature
TA Rando and RA Fishman
Department of Neurology, University of California, School of Medicine, San Francisco 94143. We report two patients with spontaneous intracranial hypotension. In addition to the cardinal features of a postural headache and a low CSF pressure, the patients also had subdural fluid collections demonstrated by head MRI. In both patients, radionuclide cisternography revealed a CSF leak along the spinal axis and rapid accumulation of radioisotope in the bladder. CSF leakage from spinal meningeal defects may be the most common

23. Neurology -- Sign In Page
Spontaneous intracranial hypotension is increasingly recognized as an important The vast majority of patients with spontaneous intracranial hypotension
http://www.neurology.org/cgi/content/full/64/7/1282
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Cranial MRI predicts outcome of spontaneous intracranial hypotension
Schievink et al. Neurology.
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Idiopathic intracranial hypertension
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24. BioMed Central | Full Text | Spontaneous Intracranial Hypotension
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25. BioMed Central | Abstract | Spontaneous Intracranial Hypotension
Spontaneous intracranial hypotension Bahram Mokri MD Spontaneous intracranial hypotension (SIH) is typically manifested by orthostatic headaches that
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26. BrainTalk Communities - Question(with MRI Attached): Is This Spontaneous Intracr
6months onto recovery of Spontanious intracranial hypotension help re spontaneous intracranial hypotension, seesha, CSF Leak, 18, 02-11-2005 0540 PM
http://brain.hastypastry.net/forums/showthread.php?goto=newpost&t=92952

27. BrainTalk Communities - 6months Onto Recovery Of Spontanious Intracranial Hypote
6months onto recovery of Spontanious intracranial hypotension that I displayed most of the classic symptoms of Spontanious intracranial hypotension I
http://brain.hastypastry.net/forums/archive/index.php/t-19358.html
BrainTalk Communities Specific Neurological Conditions (A - L) CSF Leak PDA View Full Version : 6months onto recovery of Spontanious Intracranial Hypotension gc_mcgregor@yahoo.com 06-03-2004, 01:01 PM Hi Guys, I am new to the forum, wish I had discovered it last year when I was feeling like the only person in Scotland who had ever heard of a CSF leak.
My story is a familar one and I now know now that I displayed most of the classic symptoms of Spontanious Intracranial Hypotension - I got sick in May 2003 after never suffering from headaches before.
ER department missed these symptoms, as did local GP.
Diagnosis came after 6 weeks via MRI showing sunken brain and hygromas. I had a bad experience with NHS (I ended up going private)
They never found the leak and never found out what caused it. My treatment was simple, bed rest for three months and follow up MRIs - the neurosurgeons in Scotland didn't seem to want to go down the blood patch route.
I know I have escaped lightly compaired to many on the board, however I would be grateful for some advice:
I suffered from what I can only describe as chronic fatigue until January 2004, as well as fatigue the other major symptoms were a low level ache at the base of my head and very sore achey upper back and shoulders . I also often had a pressure change in my head (a low lever whoosh) when I stood up. I had a course of pyhsio for the shoulder ache which has helped. The pyhsio put it down to being sedentry for so long.

28. Southern Medical Journal: Spontaneous Intracranial Hypotension.
Access the article, Spontaneous intracranial hypotension. from Southern Medical Journal, a publication in the field of Health Fitness,
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Save a personal copy of any page on the Web and quickly find it again with Furl.net. It's free. Get started now. Spontaneous intracranial hypotension. Southern Medical Journal November, 2002 by Finkel, Alan Content provided
in partnership with Read the full article with a Free Trial of HighBeam Research ABSTRACT: Spontaneous intracranial hypotension (SIH) is an increasingly recognized syndrome. Postural headache with typical findings on magnetic resonance imaging (MRI) are the key to diagnosis. Delay in diagnosing this condition may subject patients to unnecessary procedures and prolong morbidity. We describe a patient with Sill and outline the important clinical and radiographic features of this syndrome. Headache due to SIH is similar to headache occurring after lumbar puncture. Patients with postural headaches should have brain MRI before lumbar puncture. Meningeal ... Read the full article with a Free Trial of HighBeam Research
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29. What Is Benign Intracranial Hypotension?
I’ve been told that I have benign intracranial hypotension. What is this?
http://www.netdoctor.co.uk/ate/heartandblood/201794.html
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Answer
Thank you for your enquiry. Benign intracranial hypertension (BIH) is also sometimes known as idiopathic intracranial hypertension, and is a rare condition affecting about 1 person in every 100,000. Anyone can be affected by it although it is most commonly seen in overweight women of childbearing age. There are no definite causes although links have been made to hormonal imbalances and weight gain.
A lumbar puncture will also show that the measurement of the cerebrospinal fluid is elevated, and a CT or MRI scan will be performed to rule out the possibility of a brain tumour. A visual field test will also be done to check if the vision has been affected. Draining some of the fluid off the spine and space surrounding the brain (by a technique called a lumbar puncture) usually brings the pressure down to normal and this may need to be repeated at regular intervals.
You will be advised to lose weight to prevent papilloedema, and tablet medication (frusemide, acetazolamide) may be required to help reduce the amount of fluid present. If these drugs and repeated lumbar punctures fail to control the BIH then a surgical shunt may be inserted to relieve the abnormal pressure, although this is relatively uncommon.

30. Intracranial Hypotension Topic - Unified Search Environment
intracranial hypotension Topic Tree Synonyms and Source Vocabularies intracranial hypotension MSH/MH/D019585 MSH/PM/D019585
http://www.use.hcn.com.au/portals/shared/subject.`Intracranial Hypotension`/home
Intracranial Hypotension Topic Tree Definition:
Reduction of CEREBROSPINAL FLUID pressure characterized clinically by HEADACHE which is maximal in an upright posture and occasionally by an abducens nerve palsy (see ABDUCENS NERVE DISEASES), neck stiffness, hearing loss (see DEAFNESS), NAUSEA, and other symptoms. This condition may be spontaneous or secondary to SPINAL PUNCTURE; NEUROSURGICAL PROCEDURES; DEHYDRATION; UREMIA; trauma (see also CRANIOCEREBRAL TRAUMA); and other processes. Chronic hypotension may be associated with subdural hematomas (see HEMATOMA, SUBDURAL) or hygromas. (From Semin Neurol 1996 Mar;16(1):5-10; Adams et al., Principles of Neurology, 6th ed, pp637-8) Synonyms and Source Vocabularies:
Intracranial Hypotension Central Nervous System Diseases

31. CNSforum | Spontaneous Intracranial Hypotension
Spontaneous intracranial hypotension. Zaatreh M and Finkel A; Spontaneous intracranial hypotension (SIH) is an increasingly recognized syndrome.
http://www.cnsforum.com/reviewitem/119713e0-e148-461f-b61a-ac03ee485695/default.
www.psychotropics.dk www.brainexplorer.org www.lundbeck.com Sitemap ... Click here to choose the edition of CNSforum that best matches your area of interest. You are here CNSforum Literature Fast Track Recommended review articles
Spontaneous intracranial hypotension
Zaatreh M and Finkel A; Southern Medical Journal 2002; 95 (11); 1342-1346 Published on CNSforum: 28 Nov 2002 Spontaneous intracranial hypotension (SIH) is an increasingly recognized syndrome. Postural headache with typical findings on magnetic resonance imaging (MRI) are the key to diagnosis. Delay in diagnosing this condition may subject patients to unnecessary procedures and prolong morbidity. We describe a patient with SIH and outline the important clinical and radiographic features of this syndrome. Headache due to SIH is similar to headache occurring after lumbar puncture. Patients with postural headaches should have brain MRI before lumbar puncture. Meningeal abnormalities with typical clinical features are helpful in establishing the diagnosis. When correctly diagnosed, SIH management, in most cases, is easy and highly effective. Last updated: 28.11.2002

32. Neurosurgery - Abstract: Volume 52(1) January 2003 P 148-152 Intracranial Hypote
January 2003, 521 intracranial hypotension after intracranial hypotension after Intraoperative Lumbar Cerebrospinal Fluid Drainage. Neurosurgery.
http://www.neurosurgery-online.com/pt/re/neurosurg/abstract.00006123-200301000-0
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PDF (672 K) Intracranial Hypotension after Intraoperative Lumbar Cerebrospinal Fluid Drainage.
Neurosurgery. 52(1):148-152, January 2003.
Samadani, Uzma M.D., Ph.D.; Huang, Jason H. M.D.; Baranov, Dmitriy M.D.; Zager, Eric L. M.D.; Grady, M. Sean M.D. Abstract:
OBJECTIVE: Intraoperative lumbar cerebrospinal fluid drainage is frequently performed in a variety of neurosurgical procedures. A retrospective review is presented of the complications of lumbar cerebrospinal fluid drainage. METHODS: The records from 75 consecutive operations requiring intraoperative lumbar cerebrospinal drainage during a 1-year period at the Hospital of the University of Pennsylvania were reviewed to assess the types of complications attributable to spinal drainage and their rates of occurrence. The operations were categorized into 46 aneurysm clippings, 21 craniotomies for tumors, and 8 other cranial base procedures. RESULTS: Two patients developed transient postoperative neurological complications as a result of intracranial hypotension that resolved after epidural blood patching, with a reexploration craniotomy to drain an epidural collection performed in one patient. A third patient in the study developed a persistent deficit when intracranial hypotension led to intraoperative transtentorial herniation, which resulted in an unusual constellation of multiple brainstem infarcts that caused cranial neuropathy.

33. Neurosurgery - UserLogin
intracranial hypotension after Intraoperative Lumbar Cerebrospinal Fluid We hypothesize that the hematoma was caused by intracranial hypotension from a
http://www.neurosurgery-online.com/pt/re/neurosurg/fulltext.00006123-200301000-0
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34. Spontaneous Intracranial Hypotension Information Diseases Database
Spontaneous intracranial hypotension,Schaltenbrand syndrome, Disease Database Information.
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2 synonyms or equivalents were found. Spontaneous intracranial hypotension
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35. Dr. Koop - CSF Leak
or from the central canal in the spinal cord. Alternative Names. intracranial hypotension. Causes, incidence, and risk factors
http://www.drkoop.com/ency/93/001068.html
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CSF leak
Definition: CSF leak is an escape of the fluid that surrounds the brain and spinal cord, from the cavities within the brain, or from the central canal in the spinal cord.
Alternative Names: Intracranial hypotension
Causes, incidence, and risk factors: The dura is the membrane that surrounds the brain and spinal cord and contains the cerebrospinal fluid (CSF). A tear in the dura may occur under the following circumstances:
  • Spontaneously After surgery:
    • Spinal Sinus Brain Head
    After penetrating head trauma.
CSF leak can also be caused by a lumbar puncture (spinal tap) or by epidural placement of catheters for anesthesia or pain medications.
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36. Spontaneous Intracranial Hypotension
Complete online version of The Encyclopaedia of Medical Imaging including text and images from The Encyclopaedia of Medical Imaging s eight book volumes
http://www.amershamhealth.com/medcyclopaedia/medical/Volume VI 1/SPONTANEOUS INT

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our commitment our company Search Medcyclopaedia for: Search marked text (mark text before you click) Browse entry words starting with: A B C D ... amershamhealth.com Spontaneous intracranial hypotension, (SIH) a syndrome with reduced CSF pressure that occurs in the absence of dural puncture, surgery or trauma. The pathogenesis is usually considered to be an occult CSF leak through small defects in the meninges with a resultant decrease in CSF volume and pressure. The characteristic headache in SIH is similar to postlumbar puncture postural headache in that it is aggravated by sitting or standing and relieved by lying down. Other associated symptoms, seen less commonly, include stiff neck, nausea and vomiting, diplopia and cranial neuropathies, producing vertigo, tinnitus, photophobia and changes in hearing. CSF may be normal or reveal increased protein, xanthochromia or lymphocytic pleocytosis. By definition, the CSF pressure in SIH is low (less than 60 mm H O) and may be unobtainable via lumbar puncture, the so-called dry tap. Treatment options for intractable headache in SIH are similar to those for postdural puncture headache and include bed rest, analgesics, sedatives, oral caffeine, intravenous hydration, epidural blood patch and epidural saline infusion. The usual clinical course of SIH in most patients is spontaneous resolution over a period of weeks to months. The diagnostic intracranial imaging findings include diffuse, intense pachymeningeal enhancement on post contrast T1-weighted sequences (

37. ► CSF Leak
Alternative Names. intracranial hypotension. Causes, incidence, and risk factors. The dura is the membrane that surrounds the brain and spinal cord and
http://www.umm.edu/ency/article/001068.htm
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CSF leak
Overview Symptoms Treatment Prevention Definition: Escape of fluid that normally surrounds the brain and spinal cord from between the cavities within the brain or from the central canal in the spinal cord.
Alternative Names: Intracranial hypotension
Causes, incidence, and risk factors: The dura is the membrane that surrounds the brain and spinal cord and contains the cerebrospinal fluid (CSF). A tear in the dura may occur under the following circumstances:
  • spontaneously after surgery:
    • spinal sinus brain head
    after penetrating head trauma.
CSF leak can also be caused by a lumbar puncture (spinal tap) or by epidural placement of catheters for anesthesia or pain medications.
CSF leak
Review Date: 7/28/2002
Reviewed By: Elaine T. Kiriakopoulos, M.D., MSc, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network.

38. Intracranial Hypotension
Medical Encyclopdia article about intracranial hypotension.
http://www.umm.edu/medical-terms/02833.htm
Intracranial hypotension
A Medical Encyclopedia Article provided by the University of Maryland Medical System A resource with information on over 4000 medical topics including: Intracranial hypotension
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39. Anesthesiology - Fulltext: Volume 85(4) October 1996 P 923-925 Spontaneous Intra
SPONTANEOUS intracranial hypotension is a syndrome identical in presentation to spinal We report eight cases of spontaneous intracranial hypotension,
http://www.anesthesiology.org/pt/re/anes/fulltext.00000542-199610000-00030.htm
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References (17)
View full size inline images Anesthesiology Volume 85(4) October 1996 pp 923-925
Spontaneous Intracranial Hypotension: A Series
Weitz, Sandra R. MD; Drasner, Kenneth MD (Weitz) Assistant Professor. (Drasner) Associate Professor. Received from the Department of Anesthesia, University of California, San Francisco. Submitted for publication March 15, 1996. Accepted for publication June 16, 1996. Address reprint requests to Dr. Weitz: Department of Anesthesia, University of California, San Francisco, 521 Parnassus Avenue, San Francisco, California 94143-0648. SPONTANEOUS intracranial hypotension is a syndrome identical in presentation to "spinal headache," but it occurs in the absence of dural puncture. The most common cause is spontaneous rupture of an arachnoid cyst with persistent leak of cerebrospinal fluid (CSF). We report eight cases of spontaneous intracranial hypotension, two of which are described in detail. All patients had an incapacitating postural headache and were successfully treated with an epidural blood injection.
Case Reports
Case 1
A 42-y-old occupational therapist in excellent health came to her primary physician seeking treatment for a severe occipital headache that worsened significantly on standing and was accompanied by nausea, vomiting, and tinnitus. Incapacitated by the headache, the patient had become bedridden. She had no reported history of duraluncture or trauma to the spinal cord. Physical examination was remarkable only for bilateral visual field defects. Lumbar puncture revealed an opening pressure of 40 mm H

40. Anesthesiology - Fulltext: Volume 101(5) November 2004 P 1238 No Granuloma And N
The socalled intracranial hypotension was leakage of cerebrospinal fluid through Dietrich CL, Smith CE Epidural granuloma and intracranial hypotension
http://www.anesthesiology.org/pt/re/anes/fulltext.00000542-200411000-00029.htm
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References (6) View full size inline images Anesthesiology Volume 101(5) November 2004 p 1238
No Granuloma and No Intracranial Hypotension
Aldrete, J Antonio M.D., M.S. Aldrete Pain Care Center, Inc., Birmingham, Alabama. aldrete@arachnoiditis.com (Accepted for publication June 16, 2004.)
To the Editor:-
The case reported by Dietrich and Smith again demonstrates that performing steroid epidural injections under fluoroscopic guidance does not absolutely prevent perforation of the dura by the needle tip, because the needle is usually advanced before the next bolus of dye is injected. Measurements of skin to epidural space in magnetic resonance imaging films showed that the posterior epidural space at C6-C7 averages 3 mm in adults; in the case in question, it was not visible in the magnetic resonance imaging in figure 1 or in the computerized tomography scan in figure 3. There are two possible explanations. One is shown in figures 1 and 2 demonstrating that the patient had Chiari I syndrome usually accompanied by a narrow posterior cervical epidural and intrathecal compartments. The other is the C6-C7 space, where a herniated nucleus pulposus is still present, displacing the dural sac posteriorly. There is no posterior epidural space in either figure 1 or figure 3, as noted before. As far as how the mass got there, if the steroid was injected epidurally, the substance loculated anteriorly where there was more room. Because the epidural space stops at the foramen magnum, it is likely that some of it went intrathecally through the previously made orifice, distributing through the subdural space above the clivus and other areas (figs. 1 and 2). However, 4 weeks is too soon to develop a granuloma, which was not seen at the time of surgery. Most likely, what the authors called

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