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J Neurosurg. 2011 Jul;115(1):113-5. doi: 10.3171/2011.2.JNS101805. Epub 2011 Mar 11.

Frequency of intracranial aneurysms in patients with spontaneous intracranial hypotension.

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  • 1Department of Neurosurgery, Cedars-Sinai Medical Center, 8631 West Third Street, Suite 800E, Los Angeles, California 90048, USA. SchievinkW@cshs.org



Spontaneous intracranial hypotension (SIH) is a significant cause of new-onset daily persistent headache. A generalized connective tissue disorder also involving the intracranial arteries has been suspected in the population with SIH. Therefore, the authors reviewed angiographic studies for the presence of intracranial aneurysms in a group of patients with SIH.


Magnetic resonance angiography studies of the brain were performed in 93 patients with SIH (mean age 43 years, range 14-86 years) and in 291 controls (mean age 56 years, range 28-78 years).


Intracranial aneurysms were detected in 8 (8.6%) of the 93 patients with SIH (95% CI 2.9%-14.3%). This incidence was higher than in the control population (3 (1.0%) of 291 (95% CI 0%-2.2%; p = 0.0007). In 7 patients the aneurysms were incidental, and in 1 patient SIH developed 5 weeks after an aneurysmal subarachnoid hemorrhage.


In this retrospective case-control study, the frequency of intracranial aneurysms among patients with SIH was significantly higher than in the control population.

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