chronic csf hypotension due to lumbar puncture

Introduction

Chronic cerebrospinal fluid (CSF) hypotension is a condition often resulting from lumbar puncture, characterized by a persistent decrease in CSF pressure. This condition can lead to various neurological symptoms, including severe headaches and other complications.

Key Insights

Orthostatic Headaches and Low CSF Pressure:
- Chronic CSF hypotension frequently presents with severe orthostatic headaches, which are headaches that worsen when standing and improve when lying down .
Meningeal Enhancement on MRI:
- Intracranial hypotension often leads to intense meningeal enhancement on MRI, which typically resolves once the CSF pressure is corrected .
Complications and Symptoms:
- Common complications include subdural hematoma, which may require surgical intervention if it transforms from acute to chronic.
- Symptoms can also include nausea, vomiting, neck stiffness, and occasionally fever.
Diagnosis and Treatment:
- Diagnosis is often confirmed by lumbar puncture showing low opening pressure and high CSF protein content .
- Effective treatments include epidural blood patches, which can provide symptom relief, although multiple patches may be necessary.
- In severe cases, subarachnoid infusion of physiological solution and intravenous fluids may be required.

Conclusion

Chronic CSF hypotension due to lumbar puncture is primarily characterized by severe orthostatic headaches and can lead to complications such as subdural hematoma. Diagnosis is confirmed through lumbar puncture and MRI findings. Treatment often involves epidural blood patches and, in severe cases, subarachnoid infusions and intravenous fluids.

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Chronic csf hypotension due to lumbar puncture

Summary

Introduction

Key Insights

Conclusion

Sources and full results

Intracranial hypotension and abducens palsy following upper spinal manipulation

Upper cervical manipulation by a chiropractor can cause intracranial hypotension and ophthalmoplegia, with MRI showing meningeal enhancement and lumbar puncture revealing low opening pressure and high CSF protein content.

[Intracranial hypotension with subdural hematoma following lumbar puncture: case report].

Lumbar puncture can cause serious adverse effects, including subdural hematoma and intracranial hypotension, and should be considered when performing the procedure.

Postcontrast meningeal MR enhancement secondary to intracranial hypotension caused by lumbar puncture.

Lumbar puncture can cause intracranial hypotension, leading to intense meningeal enhancement, which resolves on its own after correction.

[Cerebrospinal fluid hypotension after brain surgery].

Cerebrospinal fluid hypotension (CSFH) can develop after brain surgery, causing severe cerebral disorders and requiring effective therapy with subarachnoid infusions and intravenous fluio.

[Idiopathic intracranial hypotension associated with decreased blood concentration of vitamin A].

Idiopathic intracranial hypotension may be predisposing to this syndrome due to decreased blood vitamin A concentrations, which may also contribute to undetectable CSF leakage or hyperabsorption.

Intracranial hypotension secondary to lumbar nerve sleeve tear.

Leakage of spinal fluid through a needle hole in the dura can cause intracranial hypotension, leading to a thumping, throbbing headache.

P 112 A case of spontaneous intracranial hypotension with bilateral subdural haemorrhages – the value of a second look

Repeated diagnostic work-ups are crucial in identifying the correct site of CSF leakage in spontaneous intracranial hypotension cases, as just one work-up may not be enough.

MRI findings in lumbar puncture headache syndrome: abnormal dural-meningeal and dural venous sinus enhancement.

Intracranial hypotension and venodilatation may play a role in the development of post-lumbar puncture headache syndrome, with abnormal MRI findings suggesting compensatory venous expansion.

Life-threatening intracranial hypotension after diagnostic lumbar puncture

Epidural blood patch is necessary for life-threatening intracranial hypotension syndrome after diagnostic lumbar puncture, as conservative treatment may not resolve symptoms.

The pathophysiology of lumbar puncture headache

Lumbar puncture headache is caused by an abnormal distribution of craniospinal elasticity, with spinal leakage producing orthostatic headaches and epidural injections providing immediate relief.

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