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J Clin Neurosci. 2016 Dec;34:39-43. doi: 10.1016/j.jocn.2016.07.002. Epub 2016 Aug 4.

CSF hypotension: A review of its manifestations, investigation and management.

Author information

1
Department of Neurology, Flinders Medical Centre, Southern Adelaide Local Health Network, Sturt Road, Bedford Park, Adelaide, SA 5042, Australia.
2
Department of Neurology, Flinders Medical Centre, Southern Adelaide Local Health Network, Sturt Road, Bedford Park, Adelaide, SA 5042, Australia; Centre for Neuroscience, School of Medicine, Flinders University of South Australia, Bedford Park, Adelaide, SA, Australia. Electronic address: mark.slee@flinders.edu.au.

Abstract

Intracranial cerebrospinal fluid (CSF) hypotension usually arises in the context of known or suspected leak of CSF. This can be spontaneous, or due to central nervous system trauma or dural defects created during lumbar puncture or epidural anaesthesia. Spontaneous intracranial hypotension (SIH) is increasingly being recognised as a cause for orthostatic headache or spontaneous subdural haematoma where no other obvious cause is found. We review CSF physiology, the mechanism of symptom generation in CSF hypotension and the investigation and management of the syndrome. Whilst commonly mild and self-limiting, CSF hypotension may result in life threatening complications and is most often treatable. When the syndrome is severe, prolonged or complicated, epidural blood patching (EBP) is the mainstay of treatment.

KEYWORDS:

Cerebrospinal fluid; Intracranial hypotension; Spontaneous intracranial hypotension

PMID:
27499119
DOI:
10.1016/j.jocn.2016.07.002
[Indexed for MEDLINE]

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