Spontaneous Intracranial Hypotension

Abstract

(N Engl J Med. 2021;385:2173–2178) Spontaneous intracranial hypotension presents as below-normal cerebrospinal fluid (CSF) due to CSF leakage from an unknown cause. While spontaneous intracranial hypotension is treatable, it is difficult to diagnose. Imaging has identified 3 types of spontaneous spinal CSF leaks: linear tear in the dura posterolateral or ventral to the spinal cord; diffuse dilatations of the dural sac or leakage at the simple meningeal diverticula; or the space between the CSF-venous fistulas and proximal veins. It is estimated that spontaneous intracranial hypotension occurs in 4 to 5 cases per 100,000 population.