Table 1:

Diagnostic criteria for spontaneous spinal CSF leak and intracranial hypotension

Criterion A, demonstration of a spinal CSF leak (ie, presence of extrathecal CSF),
or, if criterion A not met:
Criterion B, cranial MR imaging changes of intracranial hypotension (ie, presence of subdural fluid collections, enhancement of the pachymeninges, or sagging of the brain), and the presence of at least one of the following:

  1. low opening pressure (≤60 mm H2O);

  2. spinal meningeal diverticulum;

  3. improvement of symptoms after epidural blood patching;

or, if criteria A and B not met:
Criterion C, the presence of all of the following or at least 2 of the following if typical orthostatic headaches are present:

  1. low opening pressure (≤60 mm H2O),

  2. spinal meningeal diverticulum, and

  3. improvement of symptoms after epidural blood patching.

  • Note:—Patients with onset of symptoms after dural puncture or other penetrating spinal trauma are excluded.