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Subdural Effusions in the Posterior Fossa Associated with Spontaneous Intracranial Hypotension

Published online by Cambridge University Press:  02 December 2014

Arata Watanabe ,
Toru Horikoshi ,
Mikito Uchida ,
Hidehito Koizumi ,
Hiromichi Yamazaki  and
Hiroyuki Kinouchi
Arata Watanabe*
Affiliation:
Department of Neurosurgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
Toru Horikoshi
Affiliation:
Department of Neurosurgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
Mikito Uchida
Affiliation:
Department of Neurosurgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
Hidehito Koizumi
Affiliation:
Department of Neurosurgery, Yamanashi Prefectural Central, Hospital Yamanashi, Japan
Hiromichi Yamazaki
Affiliation:
Department of Neurosurgery, Yamanashi Prefectural Central, Hospital Yamanashi, Japan
Hiroyuki Kinouchi
Affiliation:
Department of Neurosurgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
*
Department of Neurosurgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokatou, Tamaho, Yamanashi 409-3898, Japan
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Abstract:

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Background:

Misdiagnosis of spontaneous intracranial hypotension remains a problem, despite increasing recognition.

Methods:

Three patients with spontaneous intracranial hypotension presented with typical findings on lumbar puncture, magnetic resonance (MR) imaging, and radioisotope cisternography. All patients showed subdural effusions in the posterior fossa on axial T2-weighted MR imaging. Axial MR images of 112 patients with other conditions were also screened for this finding.

Results:

One of three patients had typical orthostatic headache, and the other two had continuous headache. The finding of subdural effusions in the posterior fossa on axial T2-weighted MR imaging disappeared after treatment. Similar findings were found in 14 of 112 patients with other conditions. Most of the patients were over 60 years old or had dementia or previous radiation therapy.

Conclusion:

Subdural effusions in the posterior fossa can be identified by T2-weighted axial MR imaging, and are useful for the diagnosis of spontaneous intracranial hypotension and for verifying the effectiveness of treatment.

Résumé:

RÉSUMÉ:Contexte:

Bien que l’hypotension intra-crânienne spontanée soitdiagnostiquée correctement de plus en plus fréquemment, cettepathologieestdemeuresouvent mal diagnostiquée.

Méthodes:

Chez trois patients atteints d’hypotension intracrânienne spontanée la ponctionlombaire, l’imagerie par resonance magnétique (IRM) et la cisternographie radio-isotopiquemontraient des signestypique de cettepathologie. Tous les patients avaient un épanchementdans la fosse cérébrale postérieure à l’IRM axiale pondérée en T2. L’IRMaxiale de 112 patients atteints d’autres pathologies a également été examinée à ceteffet.

Résultats:

Un des trois patients atteints d’hypotension intracrânienne spontanée avaitune céphalée orthostatiquetypique et les deuxautresavaientune céphalée continue. Les signes d’épanchement sous-dural de la fosse cérébrale postérieure à l’IRM axiale pondérée en T2 sontdisparus sous traitement. 14 des 112 patients témoins présentaient des signes de cettepathologieà l’IRM. La plupartavaient plus de 60 ans, étaient atteints de démence ouavaientété traités par radiothérapie.

Conclusions:

Les épanchements sous-duraux de la fosse cérébrale postérieure peuventêtre identifiés par l’IRM axiale pondérée en T2, un examen utile pour le diagnostic de l’hypotension intracrânienne spontanée ainsique pour vérifier l’efficacité du traitement.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 33 , Issue 2 , May 2006 , pp. 205 - 208
Copyright
Copyright © The Canadian Journal of Neurological 2006

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