title: Spinal meningeal diverticula in spontaneous intracranial hypotension: analysis of prevalence and myelographic appearance.
abstract: OBJECTIVE
  Spinal meningeal diverticula have been implicated in the pathogenesis of spontaneous intracranial hypotension and have been proposed as both diagnostic features of and therapeutic targets for the condition. We compared the prevalence and myelographic appearance of spinal diverticula in patients with SIH and healthy controls.
  
  
  METHODS
  Patients satisfying the ICHD-2 criteria for SIH were retrospectively identified. CT myelograms of 19 patients with SIH were compared with CT myelograms of 18 control patients. Images were reviewed by 2 blinded neuroradiologists. The prevalence, morphology (round versus multilobulated), size, and location (cervical, upper thoracic, lower thoracic, or lumbar) of spinal meningeal diverticula were analyzed.
  
  
  RESULTS
  There was no difference in the proportion of patients with diverticula in the SIH group compared with the control group (68% versus 44%, P = .14) or in the mean number of diverticula per patient (6.3 versus 2.2, P = .099). No difference was seen in the morphology (P = .95) or size (P = .71) of diverticula between groups. There was a difference between groups that just reached statistical significance (P = .050) in the location of the diverticula along the spinal axis, but substantial overlap was seen between groups for all spinal locations.
  
  
  CONCLUSIONS
  Despite the well-established association between spinal meningeal diverticula and SIH, we found no difference in the prevalence or myelographic appearance of diverticula in patients with SIH compared with controls. Further investigation into the role of diverticula in the diagnosis and treatment of SIH is necessary.
authors.affiliation: Departments of Radiology, Duke University Medical Center, Durham, NC 277710, USA. peter.kranz@duke.edu
authors.forename: P G
authors.initials: PG
authors.lastname: Kranz
authors.forename: S S
authors.initials: SS
authors.lastname: Stinnett
authors.forename: K T
authors.initials: KT
authors.lastname: Huang
authors.forename: L
authors.initials: L
authors.lastname: Gray
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D065634:Cerebrospinal Fluid Leak; D002559:Cerebrospinal Fluid Rhinorrhea / Q000000981:diagnostic imaging / Q000453:epidemiology; D004240:Diverticulum / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D019585:Intracranial Hypotension / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D008578:Meninges / Q000000981:diagnostic imaging; D008875:Middle Aged; D009192:Myelography; D015995:Prevalence; D012189:Retrospective Studies; D013116:Spinal Cord / Q000000981:diagnostic imaging; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed