Author:
Nowak Dennis A.,Rodiek Sven-Olaf,Zinner Jürgen,Guhlmann Albrecht,Topka Helge
Abstract
✓ The syndrome of spontaneous intracranial hypotension is characterized by orthostatic headaches in conjunction with reduced cerebrospinal fluid (CSF) pressure or CSF volume, and characteristic magnetic resonance (MR) imaging findings.
A 50-year-old man presented with a 1-year history of paroxysmal ataxia of gait and short attacks of blurred vision when he stood up from a recumbent position and began to walk. Orthostatic headache was not a feature of his clinical presentation. Magnetic resonance images of the brain revealed diffuse enhancement of the dura mater and hygromas over both cerebral convexities. Magnetic resonance images of the spine demonstrated dilated cervical epidural veins and dilation of the perimedullary veins. Radionuclide cisternography identified a CSF leakage that was localized to the T12—L1 level on subsequent myelograms and on computerized tomography scans obtained after the myelograms. An epidural blood patch was administered and visualized with tungsten powder. The patient's clinical symptoms and sites of disease on imaging completely resolved.
The unusual clinical presentation in this case—paroxysmal ataxia of gait, lack of orthostatic headaches, and dilated epidural and perimedullary venous plexus—supports a recently noted broadening of both the clinical and imaging characteristics of spontaneous intracranial hypovolemia.
Publisher
Journal of Neurosurgery Publishing Group (JNSPG)
Cited by
23 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献