Clinical and Neuroradiological Features of Spontaneous Intracranial Hypotension: Report of Two Cases.

Accession number;99A0551110
Title;Clinical and Neuroradiological Features of Spontaneous Intracranial Hypotension: Report of Two Cases.
Author; SUGANO KAZUHIKO (Juntendo Univ., Urayasu Hosp.) GOTO KEIGO (Juntendo Univ., Urayasu Hosp.) HATORI KOZO (Juntendo Univ., Urayasu Hosp.) HATTORI TATSUYA (Juntendo Univ., Urayasu Hosp.) MIWA HIDETO (Juntendo Univ., Urayasu Hosp.) TANAKA SHIGEKI (Juntendo Univ., Urayasu Hosp.) MIZUNO YOSHIKUNI (Juntendo Univ.)
Journal Title;Brain Nerve
Journal Code:Z0685A
ISSN:0006-8969
VOL.51;NO.4;PAGE.345-348(1999)
Figure&Table&Reference;FIG.3, REF.9
Pub. Country;Japan
Language;Japanese
Abstract;We report two patients with spontaneous intracranial hypotension(SIH) showing bilateral subdural hematoma. One of the two patients was a 32-year-old woman, and the other was a 27-year-old healthy woman. Both patients presented chronic, intractable, orthostatic headache with dizziness and nausea. In both patients, both general and neurological examinations were normal, and routine laboratory tests were all normal, except for dry taps of the lumbar puncture. Brain CT scans and MRI revealed thin, bilateral subdural hematomas. RI-cisternography and CT-myelography disclosed multiple extraspinal CSF leakages along the nerve root sheathes of the cervical segments and early bladder filling of the radionucleotides in both patients. These findings support an emerging hypothesis that the extraspinal CSF leakage may play a role for inducing SIH. Anatomical fragility around the nerve sheeth, especially that of the lower cervical segments, may contribute to the pathophysiogical mechanism underlying SIH. For making a prompt diagnosis of SIH and for the better understanding of the pathophysiological mechanism of SIH, RI-cisternography of the whole spinal segments is important. (author abst.)
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