Spontaneous Intracranial Hypotension (SIH)

Last edit by Alaric Steinmetz on

Synonyms: Hypoliquorrhoe

Spontaneous intracranial hypotension (SIH) is characterized by abnormally low intracranial pressure, which is usually caused by a cerebrospinal fluid leak .

Incidence

The incidence of spontaneous intracranial hypotension is estimated at approximately 5/100,000[^1].

Symptoms

Patients suffering from spontaneous intracranial hypotension experience positional headaches, which worsen particularly when standing up. The headaches are generally not progressive, but instead have a clearly defined onset, from which point onward patients experience them.

Pathophysiology

The positional nature of the headaches occurs because the low cerebrospinal fluid volume causes the brain to sag, resulting in traction on the cranial nerves and dura, with the dura of the posterior fossa being particularly sensitive to traction[^2].

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