Modern approaches to the diagnosis and treatment of spontaneous intracranial hypotension (a literature review)

Authors

DOI:

https://doi.org/10.14739/2310-1210.2022.2.235648

Keywords:

spontaneous intracranial hypotension, etiology, diagnosis, treatment

Abstract

The aim of this review is to analyze and summarize the existing evidence regarding the diagnosis and treatment of spontaneous intracranial hypotension.

Spontaneous intracranial hypotension occurs due to a decrease in cerebrospinal fluid (CSF) volume as a result of its spontaneous leakage and has a variety of clinical and neuroimaging features, sometimes different from CSF hypotension after a lumbar puncture. Anatomical changes in spontaneous CSF leakage are complex and are often associated with structural disorders of the connective tissue, weakness of certain areas of the dura mater and its diverticulosis. One consequence of decreased CSF volume is brain descent. This leads to traction of pain-sensitive brain structures and, therefore, to headaches that are orthostatic or with some orthostatic features. The methods of choice to identify the site of CSF leak are CT-myelography and radioisotope cisternography. Epidural blood patch is the main treatment in most cases.

Conclusions. The study on the most informative and minimally invasive methods to locate the site of CSF leak, conservative and surgical methods of treatment efficacy evaluation depending on the etiological factors of spontaneous intracranial hypotension are extremely important and promising scientific fields requiring further research with the development of personalized approaches considering the individual characteristics of each patient.

Author Biographies

K. A. Stepanchenko, Kharkiv Medical Academy of Postgraduate Education, Ukraine

MD, PhD, DSc, Professor of the Department of Neurology and Neurosurgery

V. H. Marchenko, Kharkiv Medical Academy of Postgraduate Education, Ukraine

MD, PhD, DSc, Professor of the Department of Neurology and Neurosurgery

Yu. V. Shmatko, Kharkiv Medical Academy of Postgraduate Education, Ukraine

MD, PhD, Associate Professor of the Department of Neurology and Neurosurgery

O. B. Bondar, Kharkiv Medical Academy of Postgraduate Education, Ukraine

MD, PhD, Assistant of the Department of Neurology and Neurosurgery

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2022-04-04

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Stepanchenko KA, Marchenko VH, Shmatko YV, Bondar OB. Modern approaches to the diagnosis and treatment of spontaneous intracranial hypotension (a literature review). Zaporozhye Medical Journal [Internet]. 2022Apr.4 [cited 2026May13];24(2):230-9. Available from: https://zmj.zsmu.edu.ua/article/view/235648

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Vol. 24 No. 2 (2022)

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