MRI findings in lumbar puncture headache syndrome: abnormal dural-meningeal and dural venous sinus enhancement.
Intracranial hypotension (IH) is a treatable cause of persistent headaches. Persistent cerebrospinal fluid (CSF) leak at a lumbar puncture (LP) site may cause IH. We present postcontrast MRI of a patient with post-lumbar-puncture headache (LPHA) showing abnormal, intense, diffuse, symmetric, contiguous dural-meningeal (pachymeningeal) enhancement of the supratentorial and infratentorial intracranial dura, including convexities, interhemispheric fissure, tentorium, and falx. MRI also showed abnormal dural venous sinus enhancement, a new finding in LPHA, suggesting compensatory venous expansion. Thus, IH and venodilatation may play a role in the development of LPHA.
Bakshi
R
R
University at Buffalo (SUNY) School of Medicine and Biomedical Sciences, USA. rbakshi@buffalo.edu
Mechtler
L L
LL
Kamran
S
S
Gosy
E
E
Bates
V E
VE
Kinkel
P R
PR
Kinkel
W R
WR
D000328:Adult; D002550:Cerebral Veins / Q000473:pathology*; D003937:Diagnosis, Differential; D004388:Dura Mater / Q000002:abnormalities* / Q000098:blood supply; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D019585:Intracranial Hypotension / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008578:Meninges / Q000002:abnormalities* / Q000098:blood supply; D013129:Spinal Puncture / Q000009:adverse effects*; D013577:Syndrome