Intracranial Hypotension

Intracranial hypotension and cerebral spinal fluid (CSF) leak

What is Intracranial hypotension?

Intracranial hypotension, also known as a cerebral spinal fluid (CSF) leak, is a condition where there is a decrease in the amount of cerebrospinal fluid (CSF) that surrounds the brain and spinal cord. This can lead to a decrease in pressure within the skull, which can cause a variety of symptoms.

What is the most common cause of Intracranial Hypotension?

The most common cause of intracranial hypotension is a spontaneous spinal fluid leak, which occurs when there is a tear or hole in the dura mater, the tough outer layer that surrounds the brain and spinal cord. A spinal fluid leak can also happen after a spinal tap, a lumbar puncture, or spinal surgery. Some people are more prone to developing a spinal fluid leak, such as those with Ehlers-Danlos syndrome, a connective tissue disorder.

What are the symptoms of Intracranial Hypotension?

Symptoms of intracranial hypotension include:

• Headache
• Neck pain
• Nausea
• Vomiting
• Dizziness
• Tinnitus
• Blurred vision
• Difficulty concentrating
• Fatigue

The headache associated with intracranial hypotension is often postural, worse when upright and improved when laying flat. These symptoms may be worse in the morning and improve during the day.

How is Intracranial Hypotension diagnosed?

Diagnosis of intracranial hypotension and CSF leak typically involves a physical examination, imaging studies such as a CT or MRI, myelography and a spinal tap to measure the pressure of the cerebrospinal fluid. Treatment options for intracranial hypotension may include bed rest, increasing fluid intake, and an epidural blood patch, which is an injection of blood near the spinal canal to seal the leak and raise the pressure of the cerebrospinal fluid. In some cases, surgery may be needed to repair the tear or hole in the dura mater.

What are treatment options for Intracranial Hypotension?

Intracranial hypotension is a rare condition that can cause significant symptoms, but it can be treated effectively with the right approach. It is important to work with an experienced neurosurgeon to determine the best course of treatment for you.

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