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Conditions Treated
Conditions Treated
Acoustic Neuroma
Adult Tethered Cord
Acromegaly
Acute Subdural Hematomas
Anaplastic Astrocytoma (AA)
Ankylosing Spondylitis
Aqueductal Stenosis
Arachnoid Cysts
Arnold Chiari Malformation
Arteriovenous Malformation (AVM)
Astrocytoma
Ballism
Basilar Invagination
Brachial Plexus Injury
Brain Aneurysm
Brain Attack (Stroke)
Brain AVM
Brain Conditions
Brain Metastases
Brainstem Glioma
Carotid Dissection
Carotid Stenosis
Carpal Tunnel Syndrome
Causalgia
Cavernous Angioma
Cerebral Aneurysms
Cerebral Contusion and Intracerebral Hematoma
Chordomas
Chorea
Chronic Subdural Hematomas
Colloid Cyst
Coma
Concussion
Congenital Dermal Sinus
Cranial GunShot Wounds
Craniopharyngioma
Craniosynostosis
Cushing's Disease
Cyst Epidermoid Tumor
Dandy Walker Syndrome
Degenerative Disc Disease
Dermoid Tumor
Disc Herniation
Dural Arteriovenous Malformations
Dystonia
Ependymoma
Epidermoid Tumor (Cyst)
Epidural Hematomas
Epilepsy
Essential Tremor
Extratemporal Lobe Epilepsies
Facet Joint Syndrome
Fibromyalgia
Frontal Lobe Epilepsy
Ganglioglioma
Glioblastoma
Germinoma
Glioma
Glomus Jugulare Tumor
Glossopharyngeal Neuralgia
Hemangioblastomas
Hemi-Facial Spasm
Hydrocephalus
Hyperhidrosis
Intracerebral Hemorrhage
Intracranial Hypotension
JPA
Low-Grade Astrocytoma
Lymphocytic Hypophysitis
Lymphoma
Malignant Nerve Sheath Tumors
Medulloblastoma
Meningioma Brain Tumor
Meralgia Paresthetica
Metastatic Brain Tumors
Moyamoya Disease
Myelomeningocele
Myelopathy
Nelson's Syndrome
Neurocysticercosis
Neurofibromatosis Type 2 and Schwannomatosis
Normal Pressure Hydrocephalus
Oligodendroglioma
Optic Nerve Glioma
Osteoarthritis of the Peripheral Joint
Osteoarthritis of the Spine
Osteomyelitis
Osteoporotic Vertebral Fractures
Parkinsons Syndrome
Pediatric Conditions
Pediatric Hydrocephalus
Peripheral Nerve Injury
Phantom Limb Pain
Pineal Tumor
Pineoblastoma
Pineocytoma
Platybasia
Postherpetic Neuralgia
Post-Traumatic Seizures
Primary CNS Lymphoma
Pseudotumor Cerebri
Radiculopathy—Cervical & Lumbar (Pinched Nerve)
Recurrent Adenomas
Rheumatoid Arthritis
Schwannomas
Scoliosis
Seizure
Skull Fracture
Slit Ventricle Syndrome
Spasticity
Spinal Arteriovenous Malformation (AVM)
Spinal Compression Fractures
Spine Conditions
Spinal Cord Injury
Spinal Cord Lipomas & Lipomyelomeningoceles
Spinal Cord Tumors
Stenosis
Subarachnoid Hemorrhage
Syringomyelia
Tethered Cord Syndrome
Thoracic Outlet Syndrome
Thyrotroph (TSH) Secreting Adenomas
Torticollis
Traumatic Hematomas
Trigeminal Neuralgia
Trochanteric Bursitis
Ulnar Nerve Entrapment
Conditions Treated
Acoustic Neuroma
Adult Tethered Cord
Acromegaly
Acute Subdural Hematomas
Anaplastic Astrocytoma (AA)
Ankylosing Spondylitis
Aqueductal Stenosis
Arachnoid Cysts
Arnold Chiari Malformation
Arteriovenous Malformation (AVM)
Astrocytoma
Ballism
Basilar Invagination
Brachial Plexus Injury
Brain Aneurysm
Brain Attack (Stroke)
Brain AVM
Brain Conditions
Brain Metastases
Brainstem Glioma
Carotid Dissection
Carotid Stenosis
Carpal Tunnel Syndrome
Causalgia
Cavernous Angioma
Cerebral Aneurysms
Cerebral Contusion and Intracerebral Hematoma
Chordomas
Chorea
Chronic Subdural Hematomas
Colloid Cyst
Coma
Concussion
Congenital Dermal Sinus
Cranial GunShot Wounds
Craniopharyngioma
Craniosynostosis
Cushing's Disease
Cyst Epidermoid Tumor
Dandy Walker Syndrome
Degenerative Disc Disease
Dermoid Tumor
Disc Herniation
Dural Arteriovenous Malformations
Dystonia
Ependymoma
Epidermoid Tumor (Cyst)
Epidural Hematomas
Epilepsy
Essential Tremor
Extratemporal Lobe Epilepsies
Facet Joint Syndrome
Fibromyalgia
Frontal Lobe Epilepsy
Ganglioglioma
Glioblastoma
Germinoma
Glioma
Glomus Jugulare Tumor
Glossopharyngeal Neuralgia
Hemangioblastomas
Hemi-Facial Spasm
Hydrocephalus
Hyperhidrosis
Intracerebral Hemorrhage
Intracranial Hypotension
JPA
Low-Grade Astrocytoma
Lymphocytic Hypophysitis
Lymphoma
Malignant Nerve Sheath Tumors
Medulloblastoma
Meningioma Brain Tumor
Meralgia Paresthetica
Metastatic Brain Tumors
Moyamoya Disease
Myelomeningocele
Myelopathy
Nelson's Syndrome
Neurocysticercosis
Neurofibromatosis Type 2 and Schwannomatosis
Normal Pressure Hydrocephalus
Oligodendroglioma
Optic Nerve Glioma
Osteoarthritis of the Peripheral Joint
Osteoarthritis of the Spine
Osteomyelitis
Osteoporotic Vertebral Fractures
Parkinsons Syndrome
Pediatric Conditions
Pediatric Hydrocephalus
Peripheral Nerve Injury
Phantom Limb Pain
Pineal Tumor
Pineoblastoma
Pineocytoma
Platybasia
Postherpetic Neuralgia
Post-Traumatic Seizures
Primary CNS Lymphoma
Pseudotumor Cerebri
Radiculopathy—Cervical & Lumbar (Pinched Nerve)
Recurrent Adenomas
Rheumatoid Arthritis
Schwannomas
Scoliosis
Seizure
Skull Fracture
Slit Ventricle Syndrome
Spasticity
Spinal Arteriovenous Malformation (AVM)
Spinal Compression Fractures
Spine Conditions
Spinal Cord Injury
Spinal Cord Lipomas & Lipomyelomeningoceles
Spinal Cord Tumors
Stenosis
Subarachnoid Hemorrhage
Syringomyelia
Tethered Cord Syndrome
Thoracic Outlet Syndrome
Thyrotroph (TSH) Secreting Adenomas
Torticollis
Traumatic Hematomas
Trigeminal Neuralgia
Trochanteric Bursitis
Ulnar Nerve Entrapment
Home
Conditions Treated
Intracranial Hypotension
Intracranial Hypotension
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About Intracranial Hypotension
General Information
Intracranial hypotension is a condition in which there is negative pressure within the brain cavity.
There are several possible causes:
Cerebrospinal fluid (CSF) leak from the spinal canal:
A leak following a lumbar puncture (spinal tap).
A defect in the dura (the covering the spinal tube).
Spontaneous, sometimes following exertion such as swinging a golf club.
A congenital weakness.
Following spinal surgery.
Following spinal trauma.
Following a shunt procedure for hydrocephalus.
Lumboperitoneal shunt.
Ventriculoperitoneal shunt with a low pressure valve.
In some cases, spinal CSF leaks can lead to a descent of the cerebellar tonsils into the spinal canal, similar to a
Chiari malformation
.
Large spinal dural defects can lead to herniation of the spinal cord into the defect.
Symptoms
The classic symptom is severe headache when upright, which is relieved when lying flat.
Other symptoms can include nausea, vomiting, double vision and difficulty with concentration.
Diagnosis
Diagnosis is usually suspected based on the postural dependency of the headache, although in many cases the diagnosis of intracranial hypotension is not considered for some time.
A contrast-enhanced brain
magnetic response imaging (MRI)
scan typically shows thickened and brightly enhancing meninges (pachymeningeal enhancement). Other findings include descent of the thalamus and cerebellar tonsils.
Continuous intracranial pressure monitoring is definitive for documenting abnormally negative intracranial pressures.
The identification of the site of CSF leak in the spinal canal can be very challenging. In some cases, the site cannot be identified. Methods include:
Dynamic myelography with fluoroscopy and
computed tomography (CT)
.
Radioisotope cisternography.
Spinal MRI.
Treatment
If the site of the spinal CSF leak can be identified, then options include:
Epidural blood patch, performed by an anesthesiologist pain management specialist.
Surgical repair of the defect.
Over-draining CSF shunts are managed by replacing the valve with one that drains less.
Lumboperitoneal shunts may have to be removed or ligated.
Outcome
If the cause of the intracranial hypotension can be identified, the outcome following treatment is typically excellent.