Spontan intrakraniell hypotension sannolikt underdiagnostiserat. Nytillkommen ortostatisk huvudvärk varnar om tillståndet
Engelsk titel: Spontaneous intracranial hypotension probably underdiagnosed. Newly occurring orthostatic headache a warning of the condition
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Författare:
Sveinsson, Olafur
;
Zachau, Anne
;
Tunelli, Jonas
;
Herrman, Lars
Email: olafur.sveinsson@karolinska.se
Språk: Swe
Antal referenser: 39
Dokumenttyp:
Översikt
UI-nummer: 11091803
Sammanfattning
Spontaneous intracranial hypotension (SIH) is an uncommon but possibly an underdiagnosed condition. Advances in neuroimaging have improved our ability to diagnose SIH. The underlying cause is a spontaneous spinal cerebrospinal fluid (CSF) leak. Orthostatic headache is the cardinal symptom. Other symptoms such as tinnitus, neck pain and diplopia are often present. MRI studies will show pachymeningeal enhancement. Other findings include descent of the brain stem and cerebellar tonsils, sometimes called ‘’sagging of the brain’’. CT-myelography is the study of choice to identify the CSF leak. The condition improves in most patients with conservative therapy (bed rest, increased fluid intake and caffeine). Epidural autologous blood patch can be an effective therapy. Surgical repair of the leak is rarely used and should be used only if autologous blood patch fails.