Spontaneous intracranial hypotension (SIH): clinical features
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Spontaneous intracranial hypotension (SIH): clinical features. Females are more frequently affected. Fully referenced neurology checklist.
Epidemiology
- Females are more frequently affected
- The peak incidence age is 40 years
- It could be familial
- There is a mechanical cause in a third of cases
Types of spinal CSF leaks
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Typical headache features
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Atypical headache features
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Auditory features
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Movement disorders
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Other associated features
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Unusual presentations
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References
- Schievink WI. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. JAMA 2006; 295:2286-2296.
- Leep Hunderfund AN, Mokri B. Orthostatic headache without CSF leak. Neurology 2008; 71:1902-1906.
- Schievink WI, Maya MM, Jean-Pierre S, Nuño M, Prasad RS, Moser FG. A classification system of spontaneous spinal CSF leaks. Neurology 2016; 87:673-679.
- Mokri B. Familial occurrence of spontaneous spinal CSF leaks: underlying connective tissue disorder. Headache 2008; 48:146-163.
- Shah VN, Dillon WP. Spontaneous intracranial hypotension with brain sagging attributable to a cerebrospinal fluid-venous fistula. JAMA Neurol 2020 (Online ahead of print).
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