11/6/2023 0 Comments Cervical spine csf leak mri![]() 2, 3 CSF-venous fistulas can also allow leakage into the epidural space in the absence of a dural tear. Spiculated osteophytes, herniated discs, and nerve root diverticula can incite small dural tears that allow CSF to leak out of the thecal sac into the extradural space. 2 It is thought to arise when mechanical stressors cause or exacerbate underlying weakness in the spinal dura, which may be exacerbated by connective tissue disease. SIH is estimated to affect 5 per 100,000 people per year, with predominance for women. 1 The term “spontaneous spinal CSF leak” may be a more accurate description of this condition, though we will continue to refer to it as SIH throughout this review. These terms can be misleading, however, because most patients have normal opening pressure. In contrast, spontaneous intracranial hypotension (SIH) or CSF hypovolemia refers to leaks that arise spontaneously. These leaks may be from iatrogenic dural defects, such as lumbar punctures or drains (secondary intracranial hypotension). The clinical syndrome of orthostatic headache that resolves with recumbency or worsens with Valsalva maneuvers raises suspicion of low CSF pressure, most frequently due to a spinal CSF leak. ![]() ABBREVIATIONS: IgG4 immunoglobulin G4 POTS postural orthostatic tachycardia syndrome SIH spontaneous intracranial hypotension SS superficial siderosis ![]()
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