Skip to main content
Log in

Spontaneous intracranial hypotension: morphological findings and CSF flow dynamics studied by MRI

  • Neuro
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

We report on a case of spontaneous intracranial hypotension (SIH) presenting with classic MR findings, such as diffuse smooth thickening and intense contrast enhancement of the dura matter, increased size of the pituitary gland and downward displacement of the brain. In this case an engorgement of the cavernous sinuses is reported as an additional imaging finding of SIH. Moreover, phase-contrast MR study of the CSF flow dynamics revealed at the level of the aqueduct a decrease of the systolic and diastolic flow volume of CSF. A normalization of the flow volume was observed when SIH subsided.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Rando TA, Fishman RA (1992) Spontaneous intracranial hypotension: report of two cases and review of the literature. Neurology 42:481–487

    Google Scholar 

  2. Christophoridis GA, Mehta BA, Landi JL, Czarnecki EJ, Piaskowski RA (1998) Spontaneous intracranial hypotension: report of four cases and review of the literature. Neuroradiology 40:636–643

    CAS  PubMed  Google Scholar 

  3. Messori A, Simonetti BF, Regnicolo L, Bella P di, Logullo F, Salvolini U (2001) Spontaneous intracranial hypotension: the value of brain measurements in diagnosis by MRI. Neuroradiology 43:453–461

    CAS  PubMed  Google Scholar 

  4. Reich JB, Sierra J, Camp W, Zanzonico P, Deck MD, Plum F (1993) Magnetic resonance imaging measurements and clinical changes accompanying transtentorial and foramen magnum brain herniation. Ann Neurol 33:159–170

    CAS  PubMed  Google Scholar 

  5. Mokri B (1999) Spontaneous cerebrospinal fluid leaks: from intracranial hypotension to cerebrospinal fluid hypovolemia evolution of a concept. Mayo Clin Proc 74:1113–1123

    CAS  PubMed  Google Scholar 

  6. Tsunoda A, Okudo O, Sato K (1997) MR height of the pituitary gland as a function of age and sex: especially physiological hypertrophy in adolescence and in climacterium. Am J Neuroradiol 18:551–554

    CAS  PubMed  Google Scholar 

  7. Henry-Feugeas M, Idy-Peretti I, Baledent O, Cornu P, Lejay H, Bittoun J, Schouman-Claeys E (2001) Cerebrospinal fluid flow waveforms MR analysis in chronic adult hydrocephalus. Invest Radiol 36:146–154

    Article  CAS  PubMed  Google Scholar 

  8. Kosmorsky GS (1995) Spontaneous intracranial hypotension: a review. J Neuro Opthalmol 15:79–83

    CAS  Google Scholar 

  9. Marcellis J, Silberstein SD (1990) Spontaneous low cerebrospinal fluid pressure headache. Headache 30:192–196

    PubMed  Google Scholar 

  10. Mokri B (2001) The Monro-Kellie hypothesis: applications in CSF volume depletion. Neurology 56:1746–1748

    CAS  PubMed  Google Scholar 

  11. Mokri B, Parisi JE, Scheithauer BW, Piegras DG, Miller GM (1995) Meningeal biopsy in intracranial hypotension: meningeal enhancement on MRI. Neurology 45:1801–1807

    CAS  PubMed  Google Scholar 

  12. Tsui EY, Ng SH, Cheung YK, Fong D, Yuen MK (2001) Spontaneous intracranial hypotension with diffuse dural enhancement of the spinal canal and transient enlargement of the pituitary gland. Eur J Radiol 38:59–63

    Article  CAS  PubMed  Google Scholar 

  13. Page RB (1983) Directional pituitary blood flow: a microcinephotographic study. Endocrinology 112:157–165

    Google Scholar 

  14. Enzmann DR, Pelc NJ (1991) Normal flow pattern of intracranial and spinal cerebrospinal fluid defined with phase-contrast cine MR imaging. Radiology 178:467–474

    CAS  PubMed  Google Scholar 

  15. Enzmann DR, Pelc NJ (1993) Cerebrospinal fluid flow measured by phase-contrast cine MR. Am J Neuroradiol 14:1301–1307

    CAS  PubMed  Google Scholar 

  16. Feinberg DA, Mark AS (1987) Human brain motion and cerebrospinal fluid circulation demonstrated with MR velocity imaging. Radiology 163:793–799

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Maria I. Argyropoulou.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Metafratzi, Z., Argyropoulou, M.I., Mokou-Kanta, C. et al. Spontaneous intracranial hypotension: morphological findings and CSF flow dynamics studied by MRI. Eur Radiol 14, 1013–1016 (2004). https://doi.org/10.1007/s00330-003-2136-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-003-2136-9

Keywords

Navigation