Spontaneous intracranial hypotension associated with transdural thoracic osteophyte reversed by primary dural repair

Case report

Devin K. BinderDepartments of Neurological Surgery and Radiology, University of California at San Francisco, California

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Vahé SarkissianDepartments of Neurological Surgery and Radiology, University of California at San Francisco, California

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William P. DillonDepartments of Neurological Surgery and Radiology, University of California at San Francisco, California

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Philip R. WeinsteinDepartments of Neurological Surgery and Radiology, University of California at San Francisco, California

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✓ Spontaneous intracranial hypotension (SIH) is an increasingly recognized syndrome associated with a specific set of clinical and imaging findings; however, determining the site of spinal cerebrospinal fluid (CSF) leakage in these patients is often difficult, and indications for surgical intervention need to be better defined. The authors report on a 55-year-old woman who presented with posture-related headache, disorientation, and memory impairment. Imaging features were consistent with SIH. Computerized tomography myelography demonstrated a large T2–3 anterior transdural osteophyte associated with a CSF fistula. After an unsuccessful trial of conservative therapy, the patient underwent median sternotomy, T2–3 discectomy and removal of osteophyte, which allowed adequate exposure for primary dural repair. Postoperatively, there was immediate and prolonged resolution of all of her symptoms. This case of SIH was caused by transdural penetration by an anterior osteophyte and CSF leakage in the upper thoracic spine, which was treated effectively by anterior exposure and primary dural repair. Aggressive surgical intervention may be required to treat upper thoracic CSF leaks refractory to other measures.

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  • 1.

    Alvarez-Linera J, , Escribano J, , Benito-León J, , Porta-Etessam J, & Rovira A: Pituitary enlargement in patients with intracranial hypotension syndrome. Neurology 55:18951897, 2000 Alvarez-Linera J, Escribano J, Benito-León J, Porta-Etessam J, Rovira A: Pituitary enlargement in patients with intracranial hypotension syndrome. Neurology 55:1895–1897, 2000

    • Search Google Scholar
    • Export Citation
  • 2.

    Beards SC, , Jackson A, , Griffiths AG, & Horsman EL: Magnetic resonance imaging of extradural blood patches: appearances from 30 min to 18 h. Br J Anaesth 71:182188, 1993 Beards SC, Jackson A, Griffiths AG, Horsman EL: Magnetic resonance imaging of extradural blood patches: appearances from 30 min to 18 h. Br J Anaesth 71:182–188, 1993

    • Search Google Scholar
    • Export Citation
  • 3.

    Beck CE, , Rizk NW, , Kiger LT, , Spencer D, , Hill L, & Adler JR: Intracranial hypotension presenting with severe encephalopathy. Case report. J Neurosurg 89:470473, 1998 Beck CE, Rizk NW, Kiger LT, Spencer D, Hill L, Adler JR: Intracranial hypotension presenting with severe encephalopathy. Case report. J Neurosurg 89:470–473, 1998

    • Search Google Scholar
    • Export Citation
  • 4.

    Bell WE, , Joynt RJ, & Sahs AL: Low spinal fluid pressure syndromes. Neurology 10:512521, 1960 Bell WE, Joynt RJ, Sahs AL: Low spinal fluid pressure syndromes. Neurology 10:512–521, 1960

    • Search Google Scholar
    • Export Citation
  • 5.

    Benzon HT, , Nemickas R, , Molloy RE, , Ahmad S, , Melen O, & Cohen B: Lumbar and thoracic epidural blood injections to treat spontaneous intracranial hypotension. Anesthesiology 85:920922, 1996 Benzon HT, Nemickas R, Molloy RE, Ahmad S, Melen O, Cohen B: Lumbar and thoracic epidural blood injections to treat spontaneous intracranial hypotension. Anesthesiology 85:920–922, 1996

    • Search Google Scholar
    • Export Citation
  • 6.

    Binder DK, , Dillon WP, , Fishman RA, & Schmidt MH: Intrathecal saline infusion in the treatment of obtundation associated with spontaneous intracranial hypotension: technical case report. Neurosurgery 51:830837, 2002 Binder DK, Dillon WP, Fishman RA, Schmidt MH: Intrathecal saline infusion in the treatment of obtundation associated with spontaneous intracranial hypotension: technical case report. Neurosurgery 51:830–837, 2002

    • Search Google Scholar
    • Export Citation
  • 7.

    Blank SC, , Shakir RA, , Bindoff LA, & Bradey N: Spontaneous intracranial hypotension: clinical and magnetic resonance imaging characteristics. Clin Neurol Neurosurg 99:199204, 1997 Blank SC, Shakir RA, Bindoff LA, Bradey N: Spontaneous intracranial hypotension: clinical and magnetic resonance imaging characteristics. Clin Neurol Neurosurg 99:199–204, 1997

    • Search Google Scholar
    • Export Citation
  • 8.

    Chen WT, , Fuh JL, , Lirng JF, , Lu SR, , Wu ZA, & Wang SJ: Collapsed superior ophthalmic veins in patients with spontaneous intracranial hypotension. Neurology 61:12651267, 2003 Chen WT, Fuh JL, Lirng JF, Lu SR, Wu ZA, Wang SJ: Collapsed superior ophthalmic veins in patients with spontaneous intracranial hypotension. Neurology 61:1265–1267, 2003

    • Search Google Scholar
    • Export Citation
  • 9.

    Davenport RJ, , Chataway SJ, & Warlow CP: Spontaneous intracranial hypotension from a CSF leak in a patient with Marfan's syndrome. J Neurol Neurosurg Psychiatry 59:516519, 1995 Davenport RJ, Chataway SJ, Warlow CP: Spontaneous intracranial hypotension from a CSF leak in a patient with Marfan's syndrome. J Neurol Neurosurg Psychiatry 59:516–519, 1995

    • Search Google Scholar
    • Export Citation
  • 10.

    Dillon WP: Spinal manifestations of intracranial hypotension. AJNR 22:12331234, 2001 Dillon WP: Spinal manifestations of intracranial hypotension. AJNR 22:1233–1234, 2001

    • Search Google Scholar
    • Export Citation
  • 11.

    Dillon WP, & Fishman RA: Some lessons learned about the diagnosis and treatment of spontaneous intracranial hypotension. AJNR 19:10011002, 1998 Dillon WP, Fishman RA: Some lessons learned about the diagnosis and treatment of spontaneous intracranial hypotension. AJNR 19:1001–1002, 1998

    • Search Google Scholar
    • Export Citation
  • 12.

    Dodick DW, , Bosch EP, & Lyons MK: Orthostatic headache syndrome with CSF leak secondary to bony pathology of the cervical spine. Neurology 54 (Suppl 3):A129, 2000 (Abstract) Dodick DW, Bosch EP, Lyons MK: Orthostatic headache syndrome with CSF leak secondary to bony pathology of the cervical spine. Neurology 54 (Suppl 3):A129, 2000 (Abstract)

    • Search Google Scholar
    • Export Citation
  • 13.

    Eross EJ, , Dodick DW, , Nelson KD, , Bosch P, & Lyons M: Orthostatic headache syndrome with CSF leak secondary to bony pathology of the cervical spine. Cephalalgia 22:439443, 2002 Eross EJ, Dodick DW, Nelson KD, Bosch P, Lyons M: Orthostatic headache syndrome with CSF leak secondary to bony pathology of the cervical spine. Cephalalgia 22:439–443, 2002

    • Search Google Scholar
    • Export Citation
  • 14.

    Fattori R, , Nienaber CA, , Descovich B, , Ambrosetto P, , Reggiani LB, & Pepe G, et al: Importance of dural ectasia in phenotypic assessment of Marfan's syndrome. Lancet 354:910913, 1999 Fattori R, Nienaber CA, Descovich B, Ambrosetto P, Reggiani LB, Pepe G, et al: Importance of dural ectasia in phenotypic assessment of Marfan's syndrome. Lancet 354:910–913, 1999

    • Search Google Scholar
    • Export Citation
  • 15.

    Ferrante E, , Savino A, , Brioschi A, , Marazzi R, , Donato MF, & Riva M: Transient oculomotor cranial nerves palsy in spontaneous intracranial hypotension. J Neurosurg Sci 42:177180, 1998 Ferrante E, Savino A, Brioschi A, Marazzi R, Donato MF, Riva M: Transient oculomotor cranial nerves palsy in spontaneous intracranial hypotension. J Neurosurg Sci 42:177–180, 1998

    • Search Google Scholar
    • Export Citation
  • 16.

    Fishman RA: Intracranial hypotension. Neurology 44:19811982, 1994 Fishman RA: Intracranial hypotension. Neurology 44:1981–1982, 1994

    • Search Google Scholar
    • Export Citation
  • 17.

    Fishman RA, & Dillon WP: Dural enhancement and cerebral displacement secondary to intracranial hypotension. Neurology 43:609611, 1993 Fishman RA, Dillon WP: Dural enhancement and cerebral displacement secondary to intracranial hypotension. Neurology 43:609–611, 1993

    • Search Google Scholar
    • Export Citation
  • 18.

    Fishman RA, & Dillon WP: Spontaneous intracranial hypotension causing reversible frontotemporal dementia. Neurology 59:787, 2002 Fishman RA, Dillon WP: Spontaneous intracranial hypotension causing reversible frontotemporal dementia. Neurology 59:787, 2002

    • Search Google Scholar
    • Export Citation
  • 19.

    Fukutake T, , Sakakibara R, , Mori M, , Araki M, & Hattori T: Chronic intractable headache in a patient with Marfan's syndrome. Headache 37:291295, 1997 Fukutake T, Sakakibara R, Mori M, Araki M, Hattori T: Chronic intractable headache in a patient with Marfan's syndrome. Headache 37:291–295, 1997

    • Search Google Scholar
    • Export Citation
  • 20.

    Gaukroger PB, & Brownridge P: Epidural blood patch in the treatment of spontaneous low CSF pressure headache. Pain 29:119122, 1987 Gaukroger PB, Brownridge P: Epidural blood patch in the treatment of spontaneous low CSF pressure headache. Pain 29:119–122, 1987

    • Search Google Scholar
    • Export Citation
  • 21.

    Gibson BE, , Wedel DJ, , Faust RJ, & Petersen RC: Continuous epidural saline infusion for the treatment of low CSF pressure headache. Anesthesiology 68:789791, 1988 Gibson BE, Wedel DJ, Faust RJ, Petersen RC: Continuous epidural saline infusion for the treatment of low CSF pressure headache. Anesthesiology 68:789–791, 1988

    • Search Google Scholar
    • Export Citation
  • 22.

    Hochman MS, , Naidich TP, , Kobetz SA, & Fernandez-Maitin A: Spontaneous intracranial hypotension with pachymeningeal enhancement on MRI. Neurology 42:16281630, 1992 Hochman MS, Naidich TP, Kobetz SA, Fernandez-Maitin A: Spontaneous intracranial hypotension with pachymeningeal enhancement on MRI. Neurology 42:1628–1630, 1992

    • Search Google Scholar
    • Export Citation
  • 23.

    Hong M, , Shah GV, , Adams KM, , Turner RS, & Foster NL: Spontaneous intracranial hypotension causing reversible frontotemporal dementia. Neurology 58:12851287, 2002 Hong M, Shah GV, Adams KM, Turner RS, Foster NL: Spontaneous intracranial hypotension causing reversible frontotemporal dementia. Neurology 58:1285–1287, 2002

    • Search Google Scholar
    • Export Citation
  • 24.

    Horton JC, & Fishman RA: Neurovisual findings in the syndrome of spontaneous intracranial hypotension from dural cerebrospinal fluid leak. Ophthalmology 101:244251, 1994 Horton JC, Fishman RA: Neurovisual findings in the syndrome of spontaneous intracranial hypotension from dural cerebrospinal fluid leak. Ophthalmology 101:244–251, 1994

    • Search Google Scholar
    • Export Citation
  • 25.

    Ishihara S, , Fukui S, , Otani N, , Miyazawa T, , Ohnuki A, & Kato H, et al: Evaluation of spontaneous intracranial hypotension: assessment on ICP monitoring and radiological imaging. Br J Neurosurg 15:239241, 2001 Ishihara S, Fukui S, Otani N, Miyazawa T, Ohnuki A, Kato H, et al: Evaluation of spontaneous intracranial hypotension: assessment on ICP monitoring and radiological imaging. Br J Neurosurg 15:239–241, 2001

    • Search Google Scholar
    • Export Citation
  • 26.

    Labadie EL, , van Antwerp J, & Bamford CR: Abnormal lumbar isotope cisternography in an unusual case of spontaneous hypoliquorrheic headache. Neurology 26:135139, 1976 Labadie EL, van Antwerp J, Bamford CR: Abnormal lumbar isotope cisternography in an unusual case of spontaneous hypoliquorrheic headache. Neurology 26:135–139, 1976

    • Search Google Scholar
    • Export Citation
  • 27.

    Lasater GM: Primary intracranial hypotension. The low spinal fluid pressure syndrome. Headache 10:6366, 1970 Lasater GM: Primary intracranial hypotension. The low spinal fluid pressure syndrome. Headache 10:63–66, 1970

    • Search Google Scholar
    • Export Citation
  • 28.

    Marcelis J, & Silberstein SD: Spontaneous low cerebrospinal fluid pressure headache. Headache 30:192196, 1990 Marcelis J, Silberstein SD: Spontaneous low cerebrospinal fluid pressure headache. Headache 30:192–196, 1990

    • Search Google Scholar
    • Export Citation
  • 29.

    Matsumura A, , Anno I, , Kimura H, , Ishikawa E, & Nose T: Diagnosis of spontaneous intracranial hypotension by using magnetic resonance myelography. Case report. J Neurosurg 92:873876, 2000 Matsumura A, Anno I, Kimura H, Ishikawa E, Nose T: Diagnosis of spontaneous intracranial hypotension by using magnetic resonance myelography. Case report. J Neurosurg 92:873–876, 2000

    • Search Google Scholar
    • Export Citation
  • 30.

    Messori A, , Simonetti BF, , Regnicolo L, , Di Bella P, , Logullo F, & Salvolini U: Spontaneous intracranial hypotension: the value of brain measurements in diagnosis by MRI. Neuroradiology 43:453461, 2001 Messori A, Simonetti BF, Regnicolo L, Di Bella P, Logullo F, Salvolini U: Spontaneous intracranial hypotension: the value of brain measurements in diagnosis by MRI. Neuroradiology 43:453–461, 2001

    • Search Google Scholar
    • Export Citation
  • 31.

    Mokri B: The Monro-Kellie hypothesis: applications in CSF volume depletion. Neurology 56:17461748, 2001 Mokri B: The Monro-Kellie hypothesis: applications in CSF volume depletion. Neurology 56:1746–1748, 2001

    • Search Google Scholar
    • Export Citation
  • 32.

    Mokri B: Spontaneous cerebrospinal fluid leaks: from intracranial hypotension to cerebrospinal fluid hypovolemia—evolution of a concept. Mayo Clin Proc 74:11131123, 1999 Mokri B: Spontaneous cerebrospinal fluid leaks: from intracranial hypotension to cerebrospinal fluid hypovolemia—evolution of a concept. Mayo Clin Proc 74:1113–1123, 1999

    • Search Google Scholar
    • Export Citation
  • 33.

    Mokri B, & Atkinson JL: False pituitary tumor in CSF leaks. Neurology 55:573575, 2000 Mokri B, Atkinson JL: False pituitary tumor in CSF leaks. Neurology 55:573–575, 2000

    • Search Google Scholar
    • Export Citation
  • 34.

    Mokri B, , Atkinson JL, , Dodick DW, , Miller GM, & Piepgras DG: Absent pachymeningeal gadolinium enhancement on cranial MRI despite symptomatic CSF leak. Neurology 53:402404, 1999 Mokri B, Atkinson JL, Dodick DW, Miller GM, Piepgras DG: Absent pachymeningeal gadolinium enhancement on cranial MRI despite symptomatic CSF leak. Neurology 53:402–404, 1999

    • Search Google Scholar
    • Export Citation
  • 35.

    Mokri B, , Krueger BR, , Miller GM, & Piepgras DG: Meningeal gadolinium enhancement in low-pressure headaches. Ann Neurol 30:294295, 1991 (Abstract) Mokri B, Krueger BR, Miller GM, Piepgras DG: Meningeal gadolinium enhancement in low-pressure headaches. Ann Neurol 30:294–295, 1991 (Abstract)

    • Search Google Scholar
    • Export Citation
  • 36.

    Mokri B, , Parisi JE, , Scheithauer BW, , Piepgras DG, & Miller GM: Meningeal biopsy in intracranial hypotension: meningeal enhancement on MRI. Neurology 45:18011807, 1995 Mokri B, Parisi JE, Scheithauer BW, Piepgras DG, Miller GM: Meningeal biopsy in intracranial hypotension: meningeal enhancement on MRI. Neurology 45:1801–1807, 1995

    • Search Google Scholar
    • Export Citation
  • 37.

    Mokri B, , Piepgras DG, & Miller GM: Syndrome of orthostatic headaches and diffuse pachymeningeal gadolinium enhancement. Mayo Clin Proc 72:400413, 1997 Mokri B, Piepgras DG, Miller GM: Syndrome of orthostatic headaches and diffuse pachymeningeal gadolinium enhancement. Mayo Clin Proc 72:400–413, 1997

    • Search Google Scholar
    • Export Citation
  • 38.

    Mokri B, & Posner JB: Spontaneous intracranial hypotension: the broadening clinical and imaging spectrum of CSF leaks. Neurology 55:17711772, 2000 Mokri B, Posner JB: Spontaneous intracranial hypotension: the broadening clinical and imaging spectrum of CSF leaks. Neurology 55:1771–1772, 2000

    • Search Google Scholar
    • Export Citation
  • 39.

    Molins A, , Alvarez J, , Sumalla J, , Titus F, & Codina A: Cisternographic pattern of spontaneous liquoral hypotension. Cephalalgia 10:5965, 1990 Molins A, Alvarez J, Sumalla J, Titus F, Codina A: Cisternographic pattern of spontaneous liquoral hypotension. Cephalalgia 10:59–65, 1990

    • Search Google Scholar
    • Export Citation
  • 40.

    Nosik WA: Intracranial hypotension secondary to lumbar nerve sleeve tear. JAMA 157:11101111, 1955 Nosik WA: Intracranial hypotension secondary to lumbar nerve sleeve tear. JAMA 157:1110–1111, 1955

    • Search Google Scholar
    • Export Citation
  • 41.

    Nowak DA, , Rodiek SO, , Zinner J, , Guhlmann A, & Topka H: Broadening the clinical spectrum: unusual presentation of spontaneous cerebrospinal fluid hypovolemia. Case report. J Neurosurg 98:903907, 2003 Nowak DA, Rodiek SO, Zinner J, Guhlmann A, Topka H: Broadening the clinical spectrum: unusual presentation of spontaneous cerebrospinal fluid hypovolemia. Case report. J Neurosurg 98:903–907, 2003

    • Search Google Scholar
    • Export Citation
  • 42.

    Pakiam AS, , Lee C, & Lang AE: Intracranial hypotension with parkinsonism, ataxia, and bulbar weakness. Arch Neurol 56:869872, 1999 Pakiam AS, Lee C, Lang AE: Intracranial hypotension with parkinsonism, ataxia, and bulbar weakness. Arch Neurol 56:869–872, 1999

    • Search Google Scholar
    • Export Citation
  • 43.

    Pannullo SC, , Reich JB, , Krol G, , Deck MD, & Posner JB: MRI changes in intracranial hypotension. Neurology 43:919926, 1993 Pannullo SC, Reich JB, Krol G, Deck MD, Posner JB: MRI changes in intracranial hypotension. Neurology 43:919–926, 1993

    • Search Google Scholar
    • Export Citation
  • 44.

    Pleasure SJ, , Abosch A, , Friedman J, , Ko NU, , Barbaro N, & Dillon W, et al: Spontaneous intracranial hypotension resulting in stupor caused by diencephalic compression. Neurology 50:18541857, 1998 Pleasure SJ, Abosch A, Friedman J, Ko NU, Barbaro N, Dillon W, et al: Spontaneous intracranial hypotension resulting in stupor caused by diencephalic compression. Neurology 50:1854–1857, 1998

    • Search Google Scholar
    • Export Citation
  • 45.

    Portier F, , de Minteguiaga C, , Racy E, , Huy PT, & Herman P: Spontaneous intracranial hypotension: a rare cause of labyrinthine hydrops. Ann Otol Rhinol Laryngol 111:817820, 2002 Portier F, de Minteguiaga C, Racy E, Huy PT, Herman P: Spontaneous intracranial hypotension: a rare cause of labyrinthine hydrops. Ann Otol Rhinol Laryngol 111:817–820, 2002

    • Search Google Scholar
    • Export Citation
  • 46.

    Rabin B, , Roychowdhury J, , Meyer JR, , Cohen BA, , LaPat KD, & Russell EJ: Spontaneous intracranial hypotension: spinal MR findings. AJNR 19:10341049, 1998 Rabin B, Roychowdhury J, Meyer JR, Cohen BA, LaPat KD, Russell EJ: Spontaneous intracranial hypotension: spinal MR findings. AJNR 19:1034–1049, 1998

    • Search Google Scholar
    • Export Citation
  • 47.

    Ramsbacher J, , Schilling AM, , Wolf KJ, & Brock M: Magnetic resonance myelography (MRM) as a spinal examination technique. Acta Neurochir 139:10801084, 1997 Ramsbacher J, Schilling AM, Wolf KJ, Brock M: Magnetic resonance myelography (MRM) as a spinal examination technique. Acta Neurochir 139:1080–1084, 1997

    • Search Google Scholar
    • Export Citation
  • 48.

    Rando TA, & Fishman RA: Spontaneous intracranial hypotension: report of two cases and review of the literature. Neurology 42:481487, 1992 Rando TA, Fishman RA: Spontaneous intracranial hypotension: report of two cases and review of the literature. Neurology 42:481–487, 1992

    • Search Google Scholar
    • Export Citation
  • 49.

    Sable SG, & Ramadan NM: Meningeal enhancement and low CSF pressure headache. An MRI study. Cephalalgia 11:275276, 1991 Sable SG, Ramadan NM: Meningeal enhancement and low CSF pressure headache. An MRI study. Cephalalgia 11:275–276, 1991

    • Search Google Scholar
    • Export Citation
  • 50.

    Samadani U, , Huang JH, , Baranov D, , Zager EL, & Grady MS: Intracranial hypotension after intraoperative lumbar cerebrospinal fluid drainage. Neurosurgery 52:148152, 2003 Samadani U, Huang JH, Baranov D, Zager EL, Grady MS: Intracranial hypotension after intraoperative lumbar cerebrospinal fluid drainage. Neurosurgery 52:148–152, 2003

    • Search Google Scholar
    • Export Citation
  • 51.

    Schaltenbrand G: Neuere Anschauungen zur Pathophysiologie der Liquorzirkulation. Zentralbl Neurochir 3:290300, 1938 Schaltenbrand G: Neuere Anschauungen zur Pathophysiologie der Liquorzirkulation. Zentralbl Neurochir 3:290–300, 1938

    • Search Google Scholar
    • Export Citation
  • 52.

    Schaltenbrand G: Normal and pathological physiology of the cerebrospinal fluid circulation. Lancet 1:805808, 1953 Schaltenbrand G: Normal and pathological physiology of the cerebrospinal fluid circulation. Lancet 1:805–808, 1953

    • Search Google Scholar
    • Export Citation
  • 53.

    Schievink WI: Spontaneous spinal cerebrospinal fluid leaks: a review. Neurosurg Focus 9 (1):E8, 2000 Schievink WI: Spontaneous spinal cerebrospinal fluid leaks: a review. Neurosurg Focus 9(1):E8, 2000

    • Search Google Scholar
    • Export Citation
  • 54.

    Schievink WI, , Gordon OK, & Tourje J: Connective tissue disorders with spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension: a prospective study. Neurosurgery 54:6571, 2004 Schievink WI, Gordon OK, Tourje J: Connective tissue disorders with spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension: a prospective study. Neurosurgery 54:65–71, 2004

    • Search Google Scholar
    • Export Citation
  • 55.

    Schievink WI, & Jacques L: Recurrent spontaneous spinal cerebrospinal fluid leak associated with “nude nerve root” syndrome: case report. Neurosurgery 53:12161219, 2003 Schievink WI, Jacques L: Recurrent spontaneous spinal cerebrospinal fluid leak associated with “nude nerve root” syndrome: case report. Neurosurgery 53:1216–1219, 2003

    • Search Google Scholar
    • Export Citation
  • 56.

    Schievink WI, , Meyer F, , Schrijver I, & Francke U: A syndrome of spontaneous spinal cerebrospinal fluid leaks and skeletal features of Marfan syndrome. Ann Neurol 44:458, 1998 Schievink WI, Meyer F, Schrijver I, Francke U: A syndrome of spontaneous spinal cerebrospinal fluid leaks and skeletal features of Marfan syndrome. Ann Neurol 44:458, 1998

    • Search Google Scholar
    • Export Citation
  • 57.

    Schievink WI, , Meyer FB, , Atkinson JL, & Mokri B: Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. J Neurosurg 84:598605, 1996 Schievink WI, Meyer FB, Atkinson JL, Mokri B: Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. J Neurosurg 84:598–605, 1996

    • Search Google Scholar
    • Export Citation
  • 58.

    Schievink WI, , Morreale VM, , Atkinson JL, , Meyer FB, , Piepgras DG, & Ebersold MJ: Surgical treatment of spontaneous spinal cerebrospinal fluid leaks. J Neurosurg 88:243246, 1998 Schievink WI, Morreale VM, Atkinson JL, Meyer FB, Piepgras DG, Ebersold MJ: Surgical treatment of spontaneous spinal cerebrospinal fluid leaks. J Neurosurg 88:243–246, 1998

    • Search Google Scholar
    • Export Citation
  • 59.

    Schievink WI, , Reimer R, & Folger WN: Surgical treatment of spontaneous intracranial hypotension associated with a spinal arachnoid diverticulum. Case report. J Neurosurg 80:736739, 1994 Schievink WI, Reimer R, Folger WN: Surgical treatment of spontaneous intracranial hypotension associated with a spinal arachnoid diverticulum. Case report. J Neurosurg 80:736–739, 1994

    • Search Google Scholar
    • Export Citation
  • 60.

    Schievink WI, & Smith KA: Nonpositional headache caused by spontaneous intracranial hypotension. Neurology 51:17681769, 1998 Schievink WI, Smith KA: Nonpositional headache caused by spontaneous intracranial hypotension. Neurology 51:1768–1769, 1998

    • Search Google Scholar
    • Export Citation
  • 61.

    Schievink WI, & Tourje J: Intracranial hypotension without meningeal enhancement on magnetic resonance imaging. Case report. J Neurosurg 92:475477, 2000 Schievink WI, Tourje J: Intracranial hypotension without meningeal enhancement on magnetic resonance imaging. Case report. J Neurosurg 92:475–477, 2000

    • Search Google Scholar
    • Export Citation
  • 62.

    Schievink WI, , Wijdicks EF, , Meyer FB, & Sonntag VK: Spontaneous intracranial hypotension mimicking aneurysmal subarachnoid hemorrhage. Neurosurgery 48:513517, 2001 Schievink WI, Wijdicks EF, Meyer FB, Sonntag VK: Spontaneous intracranial hypotension mimicking aneurysmal subarachnoid hemorrhage. Neurosurgery 48:513–517, 2001

    • Search Google Scholar
    • Export Citation
  • 63.

    Schrijver I, , Schievink WI, , Godfrey M, , Meyer FB, & Francke U: Spontaneous spinal cerebrospinal fluid leaks and minor skeletal features of Marfan syndrome: a microfibrillopathy. J Neurosurg 96:483489, 2002 Schrijver I, Schievink WI, Godfrey M, Meyer FB, Francke U: Spontaneous spinal cerebrospinal fluid leaks and minor skeletal features of Marfan syndrome: a microfibrillopathy. J Neurosurg 96:483–489, 2002

    • Search Google Scholar
    • Export Citation
  • 64.

    Sencakova D, , Mokri B, & McClelland RL: The efficacy of epidural blood patch in spontaneous CSF leaks. Neurology 57:19211923, 2001 Sencakova D, Mokri B, McClelland RL: The efficacy of epidural blood patch in spontaneous CSF leaks. Neurology 57:1921–1923, 2001

    • Search Google Scholar
    • Export Citation
  • 65.

    Spelle L, , Boulin A, , Tainturier C, , Visot A, , Graveleau P, & Pierot L: Neuroimaging features of spontaneous intracranial hypotension. Neuroradiology 43:622627, 2001 Spelle L, Boulin A, Tainturier C, Visot A, Graveleau P, Pierot L: Neuroimaging features of spontaneous intracranial hypotension. Neuroradiology 43:622–627, 2001

    • Search Google Scholar
    • Export Citation
  • 66.

    Szeinfeld M, , Ihmeidan IH, , Moser MM, , Machado R, , Klose KJ, & Serafini AN: Epidural blood patch: evaluation of the volume and spread of blood injected into the epidural space. Anesthesiology 64:820822, 1986 Szeinfeld M, Ihmeidan IH, Moser MM, Machado R, Klose KJ, Serafini AN: Epidural blood patch: evaluation of the volume and spread of blood injected into the epidural space. Anesthesiology 64:820–822, 1986

    • Search Google Scholar
    • Export Citation
  • 67.

    Vishteh AG, , Schievink WI, , Baskin JJ, & Sonntag VK: Cervical bone spur presenting with spontaneous intracranial hypotension. Case report. J Neurosurg 89:483484, 1998 Vishteh AG, Schievink WI, Baskin JJ, Sonntag VK: Cervical bone spur presenting with spontaneous intracranial hypotension. Case report. J Neurosurg 89:483–484, 1998

    • Search Google Scholar
    • Export Citation
  • 68.

    Warner GT: Spontaneous intracranial hypotension causing a partial third cranial nerve palsy: a novel observation. Cephalalgia 22:822823, 2002 Warner GT: Spontaneous intracranial hypotension causing a partial third cranial nerve palsy: a novel observation. Cephalalgia 22:822–823, 2002

    • Search Google Scholar
    • Export Citation
  • 69.

    Weber WE, , Heidendal GA, & de Krom MC: Primary intracranial hypotension and abnormal radionuclide cisternography. Report of a case and review of the literature. Clin Neurol Neurosurg 93:5560, 1991 Weber WE, Heidendal GA, de Krom MC: Primary intracranial hypotension and abnormal radionuclide cisternography. Report of a case and review of the literature. Clin Neurol Neurosurg 93:55–60, 1991

    • Search Google Scholar
    • Export Citation
  • 70.

    Weitz SR, & Drasner K: Spontaneous intracranial hypotension: a series. Anesthesiology 85:923925, 1996 Weitz SR, Drasner K: Spontaneous intracranial hypotension: a series. Anesthesiology 85:923–925, 1996

    • Search Google Scholar
    • Export Citation
  • 71.

    Winter SC, , Maartens NF, , Anslow P, & Teddy PJ: Spontaneous intracranial hypotension due to thoracic disc herniation. Case report. J Neurosurg (Spine 3) 96:343345, 2002 Winter SC, Maartens NF, Anslow P, Teddy PJ: Spontaneous intracranial hypotension due to thoracic disc herniation. Case report. J Neurosurg (Spine 3) 96:343–345, 2002

    • Search Google Scholar
    • Export Citation
  • 72.

    Woltman HW: Headache: a consideration of some of the more common types. Med Clin North Am 24:11591170, 1940 Woltman HW: Headache: a consideration of some of the more common types. Med Clin North Am 24:1159–1170, 1940

    • Search Google Scholar
    • Export Citation

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