Spinal meningeal diverticula, spontaneous intracranial hypotension, and superficial siderosis.

Abstract

Superficial siderosis (SS) is a rare disorder characterized by depositions of hemosiderin in the leptomeninges and subpial layer.1 Spontaneous intracranial hypotension (SIH) is an uncommon disorder characterized by excessive loss of CSF at the level of the spine.2 An association of SS and SIH has become well-established.1,3–5 In fact, a spontaneous spinal CSF leak is found in about one-third of patients with SS.1 Only one specific type of spontaneous spinal CSF leak has been reported in patients with SS, i.e., a ventral CSF leak caused by a dural tear.6 We report 2 patients with SIH and early SS who did not have a ventral spinal CSF leak but had multiple spinal meningeal diverticula, another common finding in patients with SIH, presumably reflecting an underlying generalized weakening of the dura.6 Also, serial MRIs in these patients provide insight into the timing of the development of SS in patients with SIH.