Multidisciplinary consensus guideline for the diagnosis and management of spontaneous intracranial hypotension
Abstract: Background We aimed to create a multidisciplinary consensus clinical guideline for best practice in the diagnosis, investigation and management of spontaneous intracranial hypotension (SIH) due to cerebrospinal fluid leak based on current evidence and consensus from a multidisciplinary specialist interest group (SIG).
Methods A 29-member SIG was established, with members from neurology, neuroradiology, anaesthetics, neurosurgery and patient representatives. The scope and purpose of the guideline were agreed by the SIG by consensus. The SIG then developed guideline statements for a series of question topics using a modified Delphi process. This process was supported by a systematic literature review, surveys of patients and healthcare professionals and review by several international experts on SIH.
Results SIH and its differential diagnoses should be considered in any patient presenting with orthostatic headache. First-line imaging should be MRI of the brain with contrast and the whole spine. First-line treatment is non-targeted epidural blood patch (EBP), which should be performed as early as possible. We provide criteria for performing myelography depending on the spine MRI result and response to EBP, and we outline principles of treatments. Recommendations for conservative management, symptomatic treatment of headache and management of complications of SIH are also provided.
Conclusions This multidisciplinary consensus clinical guideline has the potential to increase awareness of SIH among healthcare professionals, produce greater consistency in care, improve diagnostic accuracy, promote effective investigations and treatments and reduce disability attributable to SIH
- Location
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Deutsche Nationalbibliothek Frankfurt am Main
- Extent
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Online-Ressource
- Language
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Englisch
- Notes
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Journal of neurology, neurosurgery, and psychiatry. - 94, 10 (2023) , 835-843, ISSN: 1468-330X
- Event
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Veröffentlichung
- (where)
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Freiburg
- (who)
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Universität
- (when)
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2023
- Creator
- DOI
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10.1136/jnnp-2023-331166
- URN
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urn:nbn:de:bsz:25-freidok-2368862
- Rights
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Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
- Last update
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25.03.2025, 1:45 PM CET
Data provider
Deutsche Nationalbibliothek. If you have any questions about the object, please contact the data provider.
Associated
- Cheema, Sanjay
- Beck, Jürgen
- Matharu, Manjit Singh
- Universität
Time of origin
- 2023
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Leukozyten-Endothelinteraktionen bei der globalen zerebralen Ischämie
Prone dynamic CT myelography in spontaneous intracranial hypotension : : diagnostic need and radiation doses
Sacral dural tears as a cause of spontaneous intracranial hypotension
Support vector machine-based spontaneous intracranial hypotension detection on brain MRI
Non-invasive biomarkers for spontaneous intracranial hypotension (SIH) through phase-contrast MRI
Primary CSF-lymphatic fistula: a previously unknown cause of spontaneous intracranial hypotension
Spontaneous intracranial hypotension without CSF leakage — concept of a pathological cranial to spinal fluid shift
Outcome after surgical treatment of cerebrospinal fluid leaks in spontaneous intracranial hypotension - a matter of time
Epidural blood patching in spontaneous intracranial hypotension - do we really seal the leak?
Patient-reported symptomatology and its course in spontaneous intracranial hypotension – beware of a chameleon
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Multiple bilateral CSF-venous fistulas in spontaneous intracranial hypotension : : a therapeutic challenge
Leukozyten-Endothelinteraktionen bei der globalen zerebralen Ischämie
Prone dynamic CT myelography in spontaneous intracranial hypotension : : diagnostic need and radiation doses
Sacral dural tears as a cause of spontaneous intracranial hypotension
Support vector machine-based spontaneous intracranial hypotension detection on brain MRI
Non-invasive biomarkers for spontaneous intracranial hypotension (SIH) through phase-contrast MRI
Primary CSF-lymphatic fistula: a previously unknown cause of spontaneous intracranial hypotension
Spontaneous intracranial hypotension without CSF leakage — concept of a pathological cranial to spinal fluid shift
Outcome after surgical treatment of cerebrospinal fluid leaks in spontaneous intracranial hypotension - a matter of time
Epidural blood patching in spontaneous intracranial hypotension - do we really seal the leak?