title: Pathophysiology and management of spontaneous intracranial hypotension--a review.
abstract: Spontaneous Intracranial Hypotension is a syndrome involving reduced intracranial pressure secondary to a dural tear which occurs mostly due to connective tissue disorders such as Marfans Syndrome, and Ehler Danlos Syndrome. Patients with dural ectasias leading to CSF leakage into the subdural or epidural space classically present with orthostatic headaches and cranial nerve deficits mostly seen in cranial nerves V-VIII. Diagnosis of SIH is confirmed with the aid of neuroimaging modalities of which Cranial MR imaging is most widely used. SIH can be treated conservatively or with epidural blood patches which are now widely being used to repair dural tears, and their effectiveness is being recognized. Recently epidural injection of fibrin glue has also been used which has been found to be effective in certain patients.
authors.affiliation: Department of Neurology, South City Hospital, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Nadir Ali
authors.initials: NA
authors.lastname: Syed
authors.forename: Farhan Arshad
authors.initials: FA
authors.lastname: Mirza
authors.forename: Aqueel Hussain
authors.initials: AH
authors.lastname: Pabaney
authors.lastname: Rameez-ul-Hassan
mesh_terms: D017217:Blood Patch, Epidural; D015170:Cerebrospinal Fluid Pressure; D004824:Epidural Space; D006801:Humans; D019585:Intracranial Hypotension / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D013116:Spinal Cord / Q000473:pathology*; D013353:Subdural Effusion / Q000473:pathology* / Q000503:physiopathology; D016896:Treatment Outcome