Titre
Syndrome d'hypotension intracrânienne spontanée [Spontaneous intracranial hypotension syndrome]
Type
étude de cas
Institution
Externe
Périodique
Auteur(s)
Ben Amor, S.
Auteure/Auteur
Maeder, P.
Auteure/Auteur
Gudinchet, F.
Auteure/Auteur
Duc, C.
Auteure/Auteur
Ingvar-Maeder, M.
Auteure/Auteur
Liens vers les personnes
ISSN
0035-3787
Statut éditorial
Publié
Date de publication
1996-10
Volume
152
Numéro
10
Première page
611
Dernière page/numéro d’article
614
Peer-reviewed
Oui
Langue
français
Notes
Publication types: Case Reports ; English Abstract ; Journal Article ; Review
Résumé
Spontaneous intracranial hypotension is a rare but well known entity first described by the German neurosurgeon Schaltenbrand. We report the clinical and radiological findings of four patients (2 males, 2 females, mean age 55 years) presenting with this clinical entity and peculiar constant MRI findings. Intense postural headache was present in all patients together with a very low CSF pressure at lumbar tap although none of the patients had any history of recent lumbar puncture, spinal or cerebral surgery or cranio-cervical trauma. MRI revealed in all patients an intense meningeal enhancement and thickening which was most prominent on the dural side of the subdural space. The ventricular system was thin, presenting almost like slit ventricules. A downward shift of the cerebellar tonsils and hemorrhagic subdural collections were also observed in two patients. Biopsy of meninges performed in two patients showed fibrosis of the leptomeninges together with signs of old hemorrhage in one case. We postulate that histologic and radiologic changes are due to chronic subdural bleeding in relation with abnormal displacement of the nervous structures due to intracranial hypotension. The underlying cause of spontaneous intracranial hypotension is rarely established and the course of the disease is benign. Some authors have advocated to perform isotopic cysternography in search for a CSF leak, particularly in the spine, that could be surgically corrected. No such investigation has been conducted yet in our patients because the spontaneous evolution has been mostly favorable.
PID Serval
serval:BIB_1DC00856EA2B
PMID
Date de création
2008-04-08T13:38:12.297Z
Date de création dans IRIS
2025-05-20T13:54:29Z