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Improved Turnaround Times | Median time to first decision: 12 days

OtherSpine Imaging and Spine Image-Guided Interventions

Consensus Guidelines on Diagnostic Brain and Spine Imaging of Spontaneous Intracranial Hypotension

Peter G. Kranz, Timothy J. Amrhein, Waleed Brinjikji, Andrew L. Callen, Ian Carroll, J. Levi Chazen, Jeremy Cutsforth-Gregory, Deborah I. Friedman, Troy A. Hutchins, Vance T. Lehman, Ajay A. Madhavan, Mark D. Mamlouk, Ian T. Mark, Marcel M. Maya, Franklin G. Moser, Simy K. Parikh, Wouter I. Schievink, Lubdha M. Shah, Vinil N. Shah, Ashesh A. Thaker and John E. Jordan
American Journal of Neuroradiology December 2025, 46 (12) 2457-2467; DOI: https://doi.org/10.3174/ajnr.A9017
Peter G. Kranz
aFrom the Department of Radiology (P.G.K., T.J.A.), Duke University Medical Center, Durham, North Carolina
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Timothy J. Amrhein
aFrom the Department of Radiology (P.G.K., T.J.A.), Duke University Medical Center, Durham, North Carolina
bDepartment of Radiology (T.J.A.), Duke University Medical Center, Durham, North Carolina
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Waleed Brinjikji
cDepartment of Radiology and Neurosurgery (W.B.), Mayo Clinic, Rochester, Minnesota
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  • ORCID record for Waleed Brinjikji
Andrew L. Callen
fDepartment of Radiology (A.L.C.), University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Ian Carroll
gDepartment of Anesthesiology, Perioperative and Pain Medicine (I.C.), Stanford University, Palo Alto, California
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J. Levi Chazen
hDepartment of Radiology (J.L.C.), Hospital for Special Surgery, Weill Cornell Medicine, New York, New York
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Jeremy Cutsforth-Gregory
dDepartment of Radiology and Neurology (J.C.-G.), Mayo Clinic, Rochester, Minnesota
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Deborah I. Friedman
iYellow Rose of Texas Headache and Neuro-Ophthalmology (D.I.F.), Dallas, Texas
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Troy A. Hutchins
jDepartment of Radiology and Imaging Sciences (T.A.H., L.M.S.), University of Utah, Salt Lake City, Utah
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Vance T. Lehman
eDepartment of Radiology (V.T.L., A.A.M., I.T.M.), Mayo Clinic, Rochester, Minnesota
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Ajay A. Madhavan
eDepartment of Radiology (V.T.L., A.A.M., I.T.M.), Mayo Clinic, Rochester, Minnesota
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Mark D. Mamlouk
kThe Permanente Medical Group (M.D.M.), Kaiser Permanente Medical Center, Santa Clara, Santa Clara, California
lDepartment of Radiology and Biomedical Imaging (M.D.M.), University of California San Francisco, San Francisco, California
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Ian T. Mark
eDepartment of Radiology (V.T.L., A.A.M., I.T.M.), Mayo Clinic, Rochester, Minnesota
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Marcel M. Maya
mDepartment of Imaging, Cedars Sinai Medical Center (M.M.M., F.G.M., W.I.S.), Beverly Hills, California
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Franklin G. Moser
mDepartment of Imaging, Cedars Sinai Medical Center (M.M.M., F.G.M., W.I.S.), Beverly Hills, California
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Simy K. Parikh
nDepartment of Neurology (S.K.P.), Emory University, Emory Healthcare, Atlanta, Georgia
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Wouter I. Schievink
mDepartment of Imaging, Cedars Sinai Medical Center (M.M.M., F.G.M., W.I.S.), Beverly Hills, California
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Lubdha M. Shah
jDepartment of Radiology and Imaging Sciences (T.A.H., L.M.S.), University of Utah, Salt Lake City, Utah
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Vinil N. Shah
oDepartment of Radiology (V.N.S.), University of California San Francisco, San Francisco, California
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Ashesh A. Thaker
pDepartment of Radiology, (A.A.T.), Denver Health, Denver, Colorado.
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John E. Jordan
qProvidence Little Company of Mary Medical Center (J.E.J.), Torrance, California
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American Journal of Neuroradiology: 46 (12)
American Journal of Neuroradiology
Vol. 46, Issue 12
1 Dec 2025
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Cite this article
Peter G. Kranz, Timothy J. Amrhein, Waleed Brinjikji, Andrew L. Callen, Ian Carroll, J. Levi Chazen, Jeremy Cutsforth-Gregory, Deborah I. Friedman, Troy A. Hutchins, Vance T. Lehman, Ajay A. Madhavan, Mark D. Mamlouk, Ian T. Mark, Marcel M. Maya, Franklin G. Moser, Simy K. Parikh, Wouter I. Schievink, Lubdha M. Shah, Vinil N. Shah, Ashesh A. Thaker, John E. Jordan
Consensus Guidelines on Diagnostic Brain and Spine Imaging of Spontaneous Intracranial Hypotension
American Journal of Neuroradiology Dec 2025, 46 (12) 2457-2467; DOI: 10.3174/ajnr.A9017

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Consensus Guidelines SIH diagnostic imaging
Peter G. Kranz, Timothy J. Amrhein, Waleed Brinjikji, Andrew L. Callen, Ian Carroll, J. Levi Chazen, Jeremy Cutsforth-Gregory, Deborah I. Friedman, Troy A. Hutchins, Vance T. Lehman, Ajay A. Madhavan, Mark D. Mamlouk, Ian T. Mark, Marcel M. Maya, Franklin G. Moser, Simy K. Parikh, Wouter I. Schievink, Lubdha M. Shah, Vinil N. Shah, Ashesh A. Thaker, John E. Jordan
American Journal of Neuroradiology Dec 2025, 46 (12) 2457-2467; DOI: 10.3174/ajnr.A9017
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  • Article
    • Abstract
    • ABBREVIATIONS:
    • TERMINOLOGY
    • METHODS
    • TOPIC ONE: OVERVIEW AND GENERAL APPROACH TO WORK-UP
    • TOPIC TWO: BRAIN IMAGING IN SIH
    • TOPIC THREE: SPINE IMAGING, INITIAL IMAGING STRATEGY
    • TOPIC FOUR: SPINE IMAGING, MRI TECHNIQUES
    • TOPIC FIVE: SPINE IMAGING, ADVANCED MYELOGRAPHY IN PATIENTS WITH SPINAL EPIDURAL FLUID COLLECTIONS
    • TOPIC SIX: SPINE IMAGING, ADVANCED MYELOGRAPHY IN THE ABSENCE OF AN EPIDURAL FLUID COLLECTION
    • LIMITATIONS
    • CONCLUSIONS
    • Footnotes
    • REFERENCES
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  • Responses
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