Spontaneous intracranial hypotension (SIH): other investigations
Evidence-based neurology checklist on spontaneous intracranial hypotension (sih): other investigations: Lumbar puncture (LP): features Low opening pressure Lymphocytic pleocytosis: up to 200 cells/cubic mm Increased protein: up to 1g Xanthochromia Decreased CSF flow A sucking noise may be heard at…
Lumbar puncture (LP): features
- Low opening pressure
- Lymphocytic pleocytosis: up to 200 cells/cubic mm
- Increased protein: up to 1g
- Xanthochromia
- Decreased CSF flow
- A sucking noise may be heard at LP: this is due to air being drawn into the CSF space
Computed tomography (CT) myelogram: features
Digital subtraction myelography
Radionuclide cisternography
Transorbital ultrasound
References
- Schievink WI. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. JAMA 2006; 295:2286-2296.
- Schievink WI, Reimer R, Folger WN. Surgical treatment of spontaneous intracranial hypotension associated with a spinal arachnoid diverticulum. J Neurosurg 1994; 80:736-739.
- Clark MS, Diehn FE, Verdoorn JT, et al. Prevalence of hyperdense paraspinal vein sign in patients with spontaneous intracranial hypotension without dural CSF leak on standard CT myelography. Diagn Interv Radiol 2018; 24:54-59.
- Kranz PG, Amrhein TJ, Schievink WI, Karikari IO, Gray L. The "hyperdense paraspinal vein" sign: a marker of CSF-venous fistula. Am J Neuroradiol 2016; 37:1379-1381.
- Duvall JR, Robertson CE, Whealy MA, Garza I. Clinical Reasoning: an underrecognized etiology of new daily persistent headache. Neurology 2020; 94:e114-e120.
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