Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Erratum An erratum has been published Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Burtis, M. T. Articles by Brown, W. D. Search for Related Content PubMed PubMed Citation Articles by Burtis, M. T. Articles by Brown, W. D.

American Journal of Neuroradiology 26:34-38, January 2005
© 2005 American Society of Neuroradiology

Case Report
SPINE

Intradural Spinal Vein Enlargement in Craniospinal Hypotension

M. Todd Burtis^a, John L. Ulmer^a, Glenn A. Miller^b, Alexandru C. Barboli^c, Scott A. Koss^a and W. Douglas Brown^a,b,c

^a Division of Neuroradiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, WI
^b Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI
^c Department of Neurology, Medical College of Wisconsin, Milwaukee, WI

Address reprint requests and correspondence to John L. Ulmer, MD, Department of Radiology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226

Summary: We present a case of craniospinal hypotension in a 45-year-old woman with an associated epidural pseudomeningocele extending the entire length of the spine. The epidural pseudomeningocele was caused by a CSF leak at the T8 level. In addition to typical low-pressure symptoms, the epidural pseudomeningocele caused atypical symptoms characterized by positional thoracic radiculopathy. Craniospinal hypotension was associated with massive cervical epidural venous engorgement, as well as enlargement of the posterior spinal cord vein, which was reminiscent of a dural arteriovenous fistula at CT myelography. Enlargement of the posterior spinal vein is explained by the Monro-Kellie hypothesis, and the spinal analog to enlarged cerebral veins known to be associated with intracranial hypotension.

This article has been cited by other articles:

				N. Kumar Neuroimaging in Superficial Siderosis: An In-Depth Look AJNR Am. J. Neuroradiol., January 1, 2010; 31(1): 5 - 14. [Abstract] [Full Text] [PDF]

				Y. -F. Wang, J. -F. Lirng, J. -L. Fuh, S. -S. Hseu, and S. -J. Wang Heavily T2-weighted MR myelography vs CT myelography in spontaneous intracranial hypotension Neurology, December 1, 2009; 73(22): 1892 - 1898. [Abstract] [Full Text] [PDF]

				W. Schievink Spontaneous Spinal Cerebrospinal Fluid Leaks Cephalalgia, December 1, 2008; 28(12): 1345 - 1356. [Abstract] [Full Text] [PDF]

				N. Kumar, A. McKeon, A. A. Rabinstein, P. Kalina, J. E. Ahlskog, and B. Mokri SUPERFICIAL SIDEROSIS AND CSF HYPOVOLEMIA: THE DEFECT (DURAL) IN THE LINK Neurology, August 28, 2007; 69(9): 925 - 926. [Full Text] [PDF]

				P-H Tsai, J-L Fuh, J-F Lirng, and S-J Wang Heavily T2-Weighted MR Myelography in Patients With Spontaneous Intracranial Hypotension: A Case--Control Study Cephalalgia, August 1, 2007; 27(8): 929 - 934. [Abstract] [Full Text] [PDF]

				W. I. Schievink Spontaneous Spinal Cerebrospinal Fluid Leaks and Intracranial Hypotension JAMA, May 17, 2006; 295(19): 2286 - 2296. [Abstract] [Full Text] [PDF]

				S. Shimizu and M. T. Burtis "Epidural" Vertebral Venous Plexus AJNR Am. J. Neuroradiol., January 1, 2006; 27(1): 7 - 7. [Full Text] [PDF]

				A. Rai, C. Rosen, J. Carpenter, and V. Miele Epidural Blood Patch at C2: Diagnosis and Treatment of Spontaneous Intracranial Hypotension AJNR Am. J. Neuroradiol., November 1, 2005; 26(10): 2663 - 2666. [Abstract] [Full Text] [PDF]