title: Spontaneous intracranial hypotension resulting from a thoracic osteophyte.
abstract: We report a 34-year-old woman who presented with progressive postural headache and neck tightness over 1week. We confirmed the diagnosis of spontaneous intracranial hypotension (SIH) and spinal images showed a thoracic osteophyte caused the cerebrospinal fluid (CSF) leak. SIH caused by spinal CSF leak is generally thought to be a consequence of deficiency of the spinal meninges in conjunction with trivial trauma. Less commonly, spinal bony pathology can lead to SIH. We reviewed 13 reported patients with bony structural pathology related SIH. After two to three epidural blood patches, eight patients underwent surgery. They generally had good outcomes. In conclusion, even though surgical repair confers specific risks, it should be considered after repetitive failures of epidural blood patches. The long-term prognoses of surgical versus non-surgical patients warrants further investigation.
authors.affiliation: Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, 539 Zhongxiao Road, Chia-Yi City 60002, Taiwan.
authors.forename: Ling-Chien
authors.initials: LC
authors.lastname: Hung
authors.affiliation: Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, 539 Zhongxiao Road, Chia-Yi City 60002, Taiwan. Electronic address: chessergg@yahoo.com.tw.
authors.forename: Yung-Chu
authors.initials: YC
authors.lastname: Hsu
mesh_terms: D000328:Adult; D017217:Blood Patch, Epidural; D065634:Cerebrospinal Fluid Leak / Q000150:complications / Q000628:therapy; D005260:Female; D006801:Humans; D019585:Intracranial Hypotension / Q000209:etiology*; D054850:Osteophyte / Q000150:complications*; D013904:Thoracic Vertebrae / Q000473:pathology*
keywords: Cerebrospinal fluid; Osteophyte; Postural headache; Refractory headache; Spontaneous intracranial hypotension