Abstract
CSF-venous fistulas — initially described in 2014 — are a significant cause of spontaneous intracranial hypotension. Dynamic lateral decubitus digital subtraction and/or CT myelography typically show a hyperdense paraspinal vein. In case of a central drainage toward the internal vertebral venous plexus, it is the “hyperdense basivertebral vein” which should be searched for carefully.
Highlights
Besides ventral dural tears and leaking meningeal diverticulas, CSF-venous fistulas (CVFs) — initially described by Schievink et al in 2014 [1] — are a significant cause of spontaneous intracranial hypotension (SIH)
On CT myelography (CTM), abnormal veins of a CVF were seen in a paravertebral location in 45%, centrally within the internal vertebral venous plexus in 32%, and lateral to the spine in 23% of patients, respectively [2]
The relative incidence of CVFs has increased due to improved diagnostic work-up using lateral decubitus Digital subtraction myelography (DSM) and/or CTM [2, 4, 5]
Summary
Besides ventral dural tears and leaking meningeal diverticulas, CSF-venous fistulas (CVFs) — initially described by Schievink et al in 2014 [1] — are a significant cause of spontaneous intracranial hypotension (SIH). On CT myelography (CTM), abnormal veins of a CVF were seen in a paravertebral location in 45%, centrally within the internal vertebral venous plexus in 32%, and lateral to the spine in 23% of patients, respectively [2].
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