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Spontaneous intracranial hypotension may present with nonorthostatic headache, normal test findings


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Journal
JAMA Neurology
Reuters Health - 05/01/2021 - A systematic review and meta-analysis of spontaneous intracranial hypotension (SIH) revealed that the commonly misdiagnosed disorder should not be excluded in patients with nonorthostatic headache, normal neuroimaging findings, or normal lumbar puncture opening pressure. "This disorder is highly disabling, as sufferers struggle to remain upright without developing severe symptoms and therefore have poor quality of life," Dr. Manjit Singh Matharu of UCL Queen Square Institute of Neurology in London told Reuters Health by email. "Despite being a common and debilitating disease, it is currently highly underrecognized." His team embarked on the study to raise awareness of the disorder and highlight knowledge gaps, he said. Take-home messages for clinicians include the following, according to Dr. Matharu: - Most SIH patients have an orthostatic or positional headache, but "a small minority" do not; - Brain imaging, especially w...


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