MRI changes in intracranial hypotension Journal Article


Authors: Pannullo, S. C.; Reich, J. B.; Krol, G.; Deck, M. D. F.; Posner, J. B.
Article Title: MRI changes in intracranial hypotension
Abstract: We report seven patients with the syndrome of intracranial hypotension who were referred to Memorial Sloan-Kettering, primarily because of suspicion of meningeal tumor or infection raised by the finding of meningeal enhancement on MRI. In three patients, symptoms occurred after lumbar puncture; in four, there was no clear precipitating event. Lumbar puncture after MRI in six patients revealed low CSF pressure (six patients) and pleocytosis or high protein, or both (four patients). Three patients had subdural effusions. Six patients had measurable descent of the brain on midsagittal images. Postural headache resolved in all seven patients, six of whom had follow-up MRIs. Meningeal enhancement resolved or diminished in all six. Subdural effusions resolved spontaneously in two and were evacuated (but were not under pressure) in one. Downward brain displacement improved or resolved in all patients. The clinical syndrome and MRI abnormalities generally resolve on their own. An extensive workup is not helpful and may be misleading. Patients should be treated symptomatically. © 1993 American Academy of Neurology.
Keywords: adult; clinical article; aged; case report; nuclear magnetic resonance imaging; magnetic resonance imaging; cerebellum; protein; brain; lumbar puncture; meningeal neoplasms; syndrome; headache; meningitis; neurologic examination; middle age; intracranial pressure; pleocytosis; protein cerebrospinal fluid level; human; male; female; priority journal; article; subdural effusion; cerebrospinal fluid pressure
Journal Title: Neurology
Volume: 43
Issue: 5
ISSN: 0028-3878
Publisher: Lippincott Williams & Wilkins  
Date Published: 1993-05-01
Start Page: 919
End Page: 926
Language: English
PUBMED: 8492946
PROVIDER: scopus
DOI: 10.1212/WNL.43.5.919
DOI/URL:
Notes: Article -- Export Date: 1 March 2019 -- Source: Scopus
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MSK Authors
  1. Jerome B Posner
    205 Posner
  2. George Krol
    84 Krol