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Spontan İntrakraniyal Hipotansiyon: Kranial ve Spinal MRG Bulguları

Year 2017, Volume: 70 Issue: 1, 57 - 61, 21.04.2017
https://doi.org/10.1501/Tipfak_0000000964

Abstract

Amaç: Spontan intrakranial hipotansiyon, nadir görülen bir sendrom olup, düșük beyin omurilik sıvısı (BOS) basıncı ile ilișkili ortostatik baș ağrısı ile karakterizedir. Bu çalıșmanın amacı, spontan intrakranial hipotansiyonun kranial ve spinal magnetik rezonans görüntüleme (MRG) bulgularının kliniğimize bașvuran hastalar eșliğinde incelenmesidir. 

Gereç ve Yöntem: Șubat 2013- Haziran 2014 tarihleri arasında kliniğimizde tanı alan 5 (4 kadın, 1 erkek) spontan intrakranial hipotansiyon olgusu çalıșmaya dahil edildi. Hastaların geliș semptomları, kranial MRG bulguları ve bir hastanın ek olarak spinal MRG bulguları incelendi. 

Bulgular: Hastaların tümü ortostatik baș ağrısı ile bașvurdu. Diğer semptomlar arasında vertigo, mide bulantısı ve tinnitus bulunmakta idi. Kontrastlı kranial MRG incelemesinde, tüm hastalarda pakimeningeal kontrast tutulumu, venöz yapılarda angorjman, subdural hematom, hipofizer hiperemi saptandı. Bir hastada bu bulgulara ek olarak, bilateral amigdala ve parahipokampal girusta inferiora doğru herniasyon mevcuttu. Diğer bir hastada ise spinal MRG’de ekstradural sıvı koleksiyonu ve venöz yapılarda belirginleșme saptandı. 

Sonuç: Ortostatik baș ağrısı tarifleyen olgularda ayırıcı tanıda spontan intrakranial hipotansiyon düșünülmelidir. MRG tipik bulguların gösterilmesinde ve tanının doğrulanmasında invaziv olmayan altın standart görüntüleme yöntemidir. 

References

  • 1.Schievink WI, Tourje J. Intracranial hypotension without meningeal enhancement on magnetic resonance imaging. J Neurosurg 2000; 92; 3:475-477.
  • 2.Grimaldi D, Mea E, Chiapparini L, et al. Spontaneous low cerebrospinal pressure: a mini review. Neurol Sci. 2004; 25: 135-137
  • 3. Rahman M, Bidari SS, Quisling RG, et al. Spontaneous intracranial hypotension: dilemmas in diagnosis. Neurosurgery. 2011; 69:4-14.
  • 4. Schievink WI. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. JAMA. 2006; 17;295:2286-2296.
  • 5. Schievink WI, Maya MM, Louy C. Cranial MRI predicts outcome of spontaneous intracranial hypotension. Neurology. 2005; 64:1282-1284.
  • 6. Couch JR. Spontaneous Spontaneous intracranial hypotension: the syndrome and its complications. Curr Treat Options Neurol. 2008; 10:3-11.
  • 7. Evan RW, Mokri B. Spontaneous intracranial hipotension resulting in coma. Headache 2002; 42: 159-160.
  • 8. Hong M, Shah GV, Adams KM, et al. Spontaneous intracranial hipotension causing reversible frontotemporal dementia. Neurology 2002; 58: 1285-1287.
  • 9. Hız F, Karagol T, Eyiipgil T, et al. The Abducens Nerve Palsy Due to Spontan Intracranial Hypotension Syndrome. Turkish Jpornal of Neurology 2007; 13: 345-350.
  • 10. Haritanti A, Karacostas D, Drevelengas A, et al. Spontaneous intracranial hypotension: clinical and neuroimaging findings in six cases with literature review. Eur J Radiol. 2009; 69:253-259.
  • 11. Gordon N. Spontaneous intracranial hypotension. Dev Med Child Neurol. 09;51:932-935.
  • 12. Horton JC, Fishman RA. Neurovisual findings in the syndrome of spontaneous intracranial hypotension from dural cerebrospinal fluid leak. Ophthalmology 1994; 101; 244-251.
  • 13. Schievink WI, Meyer FB, Atkinson JLD, et al. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. J Neurosurg. 1996; 84: 598-605.
  • 14. Chen HH, Huang CI, Hseu SS, et al. Bilateral subdural hematomas caused by spontaneous intracranial hypotension. J Chin Med Assoc. 2008; 71:147-151.
  • 15. Ferrante E, Riva M, Gatti A, et al. Intracranial hypotension syndrome: neuroimaging in five spontaneous cases and etiopathogenetic correlations. Clin Neurol Neurosurg. 1998; 100:33-39
  • 16. Whitely W, Al-Shahi R, Myles L, et al. Spontaneous intracranial hypotension causing confusion and coma. Br J Neurosurg. 2003;
  • 17: 456-458. 17. Zada G, Solomon TC, Giannotta SL. A review of ocular manifestations in intracranial hypotension. Neurosurg 2007; 23 : 1-5.
  • 18. Altınkaya N, Yıldırım T, Yerdelen D, ve ark. Primer ve sekonder İH: klinik izlem, MRG ve radyoizotop sisternografi bulguları. Turk Norol Derg 2010;16.78-85.
  • 19. Schievink WI, Tourje J. Intracranial hypotension without meningeal enhancement on magnetic resonance imaging. J Neurosurg 2000; 92; 3:475-477.
  • 20. Schoffer KI, Benstead TJ, Grant I. Spontaneous intracranial hypotension in the absence of magnetic resonance imaging abnormalities. Can J Neurol. Sci. 2002; 29 : 253-257.
  • 21. Karakurum Göksel B. Spontaneous intracranial hypotension. İst Tıp Fak Derg 2013; 76:2
  • 22. Medina JH, Abrams K, Falcone S, et al. Spinal imaging findings in spontaneous intracranial hypotension. AJR Am J Roentgenol. 2010; 195:459-464.
  • 23. Takashi K, Mima T. Cerebrospinal fluid leakage after radioisotope cisternography is not influenced by needle size at lumbar puncture in patients with intracranial hypotension. Cerebrospinal Fluid Research 2009; 6: 1-6.
  • 24. Park ES, Kim E. Spontaneous intracranial hypotension: clinical presentation, imaging features and treatment. J Korean Neurosurg Soc. 2009; 45:1-4.
Year 2017, Volume: 70 Issue: 1, 57 - 61, 21.04.2017
https://doi.org/10.1501/Tipfak_0000000964

Abstract

References

  • 1.Schievink WI, Tourje J. Intracranial hypotension without meningeal enhancement on magnetic resonance imaging. J Neurosurg 2000; 92; 3:475-477.
  • 2.Grimaldi D, Mea E, Chiapparini L, et al. Spontaneous low cerebrospinal pressure: a mini review. Neurol Sci. 2004; 25: 135-137
  • 3. Rahman M, Bidari SS, Quisling RG, et al. Spontaneous intracranial hypotension: dilemmas in diagnosis. Neurosurgery. 2011; 69:4-14.
  • 4. Schievink WI. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. JAMA. 2006; 17;295:2286-2296.
  • 5. Schievink WI, Maya MM, Louy C. Cranial MRI predicts outcome of spontaneous intracranial hypotension. Neurology. 2005; 64:1282-1284.
  • 6. Couch JR. Spontaneous Spontaneous intracranial hypotension: the syndrome and its complications. Curr Treat Options Neurol. 2008; 10:3-11.
  • 7. Evan RW, Mokri B. Spontaneous intracranial hipotension resulting in coma. Headache 2002; 42: 159-160.
  • 8. Hong M, Shah GV, Adams KM, et al. Spontaneous intracranial hipotension causing reversible frontotemporal dementia. Neurology 2002; 58: 1285-1287.
  • 9. Hız F, Karagol T, Eyiipgil T, et al. The Abducens Nerve Palsy Due to Spontan Intracranial Hypotension Syndrome. Turkish Jpornal of Neurology 2007; 13: 345-350.
  • 10. Haritanti A, Karacostas D, Drevelengas A, et al. Spontaneous intracranial hypotension: clinical and neuroimaging findings in six cases with literature review. Eur J Radiol. 2009; 69:253-259.
  • 11. Gordon N. Spontaneous intracranial hypotension. Dev Med Child Neurol. 09;51:932-935.
  • 12. Horton JC, Fishman RA. Neurovisual findings in the syndrome of spontaneous intracranial hypotension from dural cerebrospinal fluid leak. Ophthalmology 1994; 101; 244-251.
  • 13. Schievink WI, Meyer FB, Atkinson JLD, et al. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. J Neurosurg. 1996; 84: 598-605.
  • 14. Chen HH, Huang CI, Hseu SS, et al. Bilateral subdural hematomas caused by spontaneous intracranial hypotension. J Chin Med Assoc. 2008; 71:147-151.
  • 15. Ferrante E, Riva M, Gatti A, et al. Intracranial hypotension syndrome: neuroimaging in five spontaneous cases and etiopathogenetic correlations. Clin Neurol Neurosurg. 1998; 100:33-39
  • 16. Whitely W, Al-Shahi R, Myles L, et al. Spontaneous intracranial hypotension causing confusion and coma. Br J Neurosurg. 2003;
  • 17: 456-458. 17. Zada G, Solomon TC, Giannotta SL. A review of ocular manifestations in intracranial hypotension. Neurosurg 2007; 23 : 1-5.
  • 18. Altınkaya N, Yıldırım T, Yerdelen D, ve ark. Primer ve sekonder İH: klinik izlem, MRG ve radyoizotop sisternografi bulguları. Turk Norol Derg 2010;16.78-85.
  • 19. Schievink WI, Tourje J. Intracranial hypotension without meningeal enhancement on magnetic resonance imaging. J Neurosurg 2000; 92; 3:475-477.
  • 20. Schoffer KI, Benstead TJ, Grant I. Spontaneous intracranial hypotension in the absence of magnetic resonance imaging abnormalities. Can J Neurol. Sci. 2002; 29 : 253-257.
  • 21. Karakurum Göksel B. Spontaneous intracranial hypotension. İst Tıp Fak Derg 2013; 76:2
  • 22. Medina JH, Abrams K, Falcone S, et al. Spinal imaging findings in spontaneous intracranial hypotension. AJR Am J Roentgenol. 2010; 195:459-464.
  • 23. Takashi K, Mima T. Cerebrospinal fluid leakage after radioisotope cisternography is not influenced by needle size at lumbar puncture in patients with intracranial hypotension. Cerebrospinal Fluid Research 2009; 6: 1-6.
  • 24. Park ES, Kim E. Spontaneous intracranial hypotension: clinical presentation, imaging features and treatment. J Korean Neurosurg Soc. 2009; 45:1-4.
There are 24 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Mehtap Çavuşoğlu This is me

Publication Date April 21, 2017
Published in Issue Year 2017 Volume: 70 Issue: 1

Cite

APA Çavuşoğlu, M. (2017). Spontan İntrakraniyal Hipotansiyon: Kranial ve Spinal MRG Bulguları. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 70(1), 57-61. https://doi.org/10.1501/Tipfak_0000000964
AMA Çavuşoğlu M. Spontan İntrakraniyal Hipotansiyon: Kranial ve Spinal MRG Bulguları. Ankara Üniversitesi Tıp Fakültesi Mecmuası. April 2017;70(1):57-61. doi:10.1501/Tipfak_0000000964
Chicago Çavuşoğlu, Mehtap. “Spontan İntrakraniyal Hipotansiyon: Kranial Ve Spinal MRG Bulguları”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 70, no. 1 (April 2017): 57-61. https://doi.org/10.1501/Tipfak_0000000964.
EndNote Çavuşoğlu M (April 1, 2017) Spontan İntrakraniyal Hipotansiyon: Kranial ve Spinal MRG Bulguları. Ankara Üniversitesi Tıp Fakültesi Mecmuası 70 1 57–61.
IEEE M. Çavuşoğlu, “Spontan İntrakraniyal Hipotansiyon: Kranial ve Spinal MRG Bulguları”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 70, no. 1, pp. 57–61, 2017, doi: 10.1501/Tipfak_0000000964.
ISNAD Çavuşoğlu, Mehtap. “Spontan İntrakraniyal Hipotansiyon: Kranial Ve Spinal MRG Bulguları”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 70/1 (April 2017), 57-61. https://doi.org/10.1501/Tipfak_0000000964.
JAMA Çavuşoğlu M. Spontan İntrakraniyal Hipotansiyon: Kranial ve Spinal MRG Bulguları. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2017;70:57–61.
MLA Çavuşoğlu, Mehtap. “Spontan İntrakraniyal Hipotansiyon: Kranial Ve Spinal MRG Bulguları”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 70, no. 1, 2017, pp. 57-61, doi:10.1501/Tipfak_0000000964.
Vancouver Çavuşoğlu M. Spontan İntrakraniyal Hipotansiyon: Kranial ve Spinal MRG Bulguları. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2017;70(1):57-61.