Imaging of the Spontaneous Low Cerebrospinal Fluid Pressure Headache: A Review

Can Assoc Radiol J. 2020 May;71(2):174-185. doi: 10.1177/0846537119888395. Epub 2020 Jan 24.

Abstract

Spontaneous intracranial hypotension (SIH) is a significant cause of chronic, postural headaches. Spontaneous intracranial hypotension is generally believed to be associated with cerebrospinal fluid (CSF) leaks, and these leaks can be posttraumatic, iatrogenic, or idiopathic in origin. An integral part of the management of patients with this condition consists of localizing and stopping the leaks. Radiologists play a central role in the workup of this condition detecting leaks using computed tomography, magnetic resonance imaging, or nuclear imaging. In this article, we briefly review SIH and the various imaging modalities, which can be used to identify and localize a spontaneous CSF leak.

Keywords: CSF leaks; CT cisternography; MR cisternography; headache; spontaneous intracranial hypotension.

Publication types

  • Review

MeSH terms

  • Cerebrospinal Fluid Leak / complications
  • Cerebrospinal Fluid Leak / diagnostic imaging*
  • Headache / diagnostic imaging*
  • Headache / etiology
  • Humans
  • Intracranial Hypotension / diagnostic imaging*
  • Intracranial Hypotension / etiology
  • Intracranial Pressure
  • Magnetic Resonance Imaging* / methods
  • Myelography / methods*
  • Radionuclide Imaging / methods
  • Tomography, X-Ray Computed* / methods