Spontaneous intracranial hypotension: Atypical radiologic appearances, imaging mimickers, and clinical look-alikes

K. M. Bond, J. C. Benson, J. K. Cutsforth-Gregory, D. K. Kim, F. E. Diehn, C. M. Carr

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

SUMMARY: Spontaneous intracranial hypotension is a condition characterized by low CSF volume secondary to leakage through a dural defect with no identifiable cause. Patients classically present with orthostatic headaches, but this symptom is not specific to spontaneous intracranial hypotension, and initial misdiagnosis is common. The most prominent features of spontaneous intracranial hypotension on intracranial MR imaging include "brain sag" and diffuse pachymeningeal enhancement, but these characteristics can be seen in several other conditions. Understanding the clinical and imaging features of spontaneous intracranial hypotension and its mimickers will lead to more prompt and accurate diagnoses. Here we discuss conditions that mimic the radiologic and clinical presentation of spontaneous intracranial hypotension as well as other disorders that CSF leaks can imitate.

Original languageEnglish (US)
Pages (from-to)1339-1347
Number of pages9
JournalAmerican Journal of Neuroradiology
Volume41
Issue number8
DOIs
StatePublished - Aug 1 2020

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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