Abstract
BackgroundRebound high-pressure headaches may complicate treatment of spontaneous intracranial hypotension (SIH), but no comprehensive study of such patients has been reported and little is known about its frequency and risk factors. We therefore studied patients undergoing treatment for SIH and performed magnetic resonance venography (MRV) to assess for cerebral venous sinus stenosis, a risk factor for idiopathic intracranial hypertension.MethodsWe studied a consecutive group of patients who underwent treatment for SIH. Rebound high-pressure headache was defined as a reverse orthostatic headache responsive to acetazolamide. MRV was obtained in all patients and lateral sinus stenosis was scored according to the system published by Higgins et al., with 0 being normal and 4 signifying bilateral signal gaps.ResultsThe mean age of the 46 men and 67 women was 45.9 years (range 13-71 years) at the time of onset of SIH. Rebound high-pressure headache was diagnosed in 31 patients (27.4%); 14% of patients with an MRV score of 0, 24% with a score of 1, and 46% with a score of 2 or 3 (p = 0.0092). Also, compared to SIH patients who did not develop rebound high-pressure headaches (n = 82), those with rebound high-pressure headaches were younger, more often female, and more often had an extradural CSF collection on spinal imaging.ConclusionsRebound high-pressure headache occurs in about one-fourth of patients following treatment of SIH and is more common in those with restriction of cerebral venous outflow.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 93-100 |
| Number of pages | 8 |
| Journal | Neurology: Clinical Practice |
| Volume | 9 |
| Issue number | 2 |
| DOIs | |
| State | Published - Apr 1 2019 |
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ASJC Scopus subject areas
- Clinical Neurology
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Rebound high-pressure headache after treatment of spontaneous intracranial hypotension : MRV study. / Schievink, Wouter I.; Maya, M. Marcel; Jean-Pierre, Stacey; Moser, Franklin G.; Nuño, Miriam; Pressman, Barry D.
In: Neurology: Clinical Practice, Vol. 9, No. 2, 01.04.2019, p. 93-100.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Rebound high-pressure headache after treatment of spontaneous intracranial hypotension
T2 - MRV study
AU - Schievink, Wouter I.
AU - Maya, M. Marcel
AU - Jean-Pierre, Stacey
AU - Moser, Franklin G.
AU - Nuño, Miriam
AU - Pressman, Barry D.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - BackgroundRebound high-pressure headaches may complicate treatment of spontaneous intracranial hypotension (SIH), but no comprehensive study of such patients has been reported and little is known about its frequency and risk factors. We therefore studied patients undergoing treatment for SIH and performed magnetic resonance venography (MRV) to assess for cerebral venous sinus stenosis, a risk factor for idiopathic intracranial hypertension.MethodsWe studied a consecutive group of patients who underwent treatment for SIH. Rebound high-pressure headache was defined as a reverse orthostatic headache responsive to acetazolamide. MRV was obtained in all patients and lateral sinus stenosis was scored according to the system published by Higgins et al., with 0 being normal and 4 signifying bilateral signal gaps.ResultsThe mean age of the 46 men and 67 women was 45.9 years (range 13-71 years) at the time of onset of SIH. Rebound high-pressure headache was diagnosed in 31 patients (27.4%); 14% of patients with an MRV score of 0, 24% with a score of 1, and 46% with a score of 2 or 3 (p = 0.0092). Also, compared to SIH patients who did not develop rebound high-pressure headaches (n = 82), those with rebound high-pressure headaches were younger, more often female, and more often had an extradural CSF collection on spinal imaging.ConclusionsRebound high-pressure headache occurs in about one-fourth of patients following treatment of SIH and is more common in those with restriction of cerebral venous outflow.
AB - BackgroundRebound high-pressure headaches may complicate treatment of spontaneous intracranial hypotension (SIH), but no comprehensive study of such patients has been reported and little is known about its frequency and risk factors. We therefore studied patients undergoing treatment for SIH and performed magnetic resonance venography (MRV) to assess for cerebral venous sinus stenosis, a risk factor for idiopathic intracranial hypertension.MethodsWe studied a consecutive group of patients who underwent treatment for SIH. Rebound high-pressure headache was defined as a reverse orthostatic headache responsive to acetazolamide. MRV was obtained in all patients and lateral sinus stenosis was scored according to the system published by Higgins et al., with 0 being normal and 4 signifying bilateral signal gaps.ResultsThe mean age of the 46 men and 67 women was 45.9 years (range 13-71 years) at the time of onset of SIH. Rebound high-pressure headache was diagnosed in 31 patients (27.4%); 14% of patients with an MRV score of 0, 24% with a score of 1, and 46% with a score of 2 or 3 (p = 0.0092). Also, compared to SIH patients who did not develop rebound high-pressure headaches (n = 82), those with rebound high-pressure headaches were younger, more often female, and more often had an extradural CSF collection on spinal imaging.ConclusionsRebound high-pressure headache occurs in about one-fourth of patients following treatment of SIH and is more common in those with restriction of cerebral venous outflow.
UR - http://www.scopus.com/inward/record.url?scp=85073617053&partnerID=8YFLogxK
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U2 - 10.1212/CPJ.0000000000000550
DO - 10.1212/CPJ.0000000000000550
M3 - Article
AN - SCOPUS:85073617053
VL - 9
SP - 93
EP - 100
JO - Neurology: Clinical Practice
JF - Neurology: Clinical Practice
SN - 2163-0402
IS - 2
ER -