Long-Term Headache Outcome and Radiological Correlates in Patients With Intracranial Hypotension

被引:0
作者
Romozzi, Marina [1 ,2 ]
Garignano, Giuseppe [3 ]
Funcis, Antonio [1 ,2 ]
Martinelli, Renata [4 ]
Rossi, Marco [5 ]
Calabresi, Paolo [1 ,2 ]
Vollono, Catello [1 ,2 ]
Signorelli, Francesco [4 ]
机构
[1] Univ Cattolica Sacro Cuore, Dept Neurosci, Rome, Italy
[2] Fdn Policlin Univ Agostino Gemelli IRCCS, Dipartimento Neurosci Organi Senso & Torace, Rome, Italy
[3] Fdn Policlin Univ Agostino Gemelli IRCCS, Dipartimento Diagnost Immagini & Radioterapia Onco, Radiol & Neuroradiol Unit, Rome, Italy
[4] Univ Cattolica Sacro Cuore, Fdn Policlin Univ Agostino Gemelli IRCCS, Depatment Neurosurg, Rome, Italy
[5] Fdn Policlin Univ Agostino Gemelli IRCCS, Dept Anesthesia & Intens Care, Rome, Italy
关键词
CSF; epidural blood patch; headache; intracranial hypotension; leak; EPIDURAL BLOOD PATCH;
D O I
10.1111/ene.70051
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BackgroundHeadache is the most common presenting symptom of intracranial hypotension (IH), and it usually has orthostatic features. However, the outcome of IH and the persistence and characteristics of headache are still overlooked.MethodsIn this cohort study, patients diagnosed with IH in our institute between 2018 and 2024 were included. Demographical and clinical data, headache characteristics, etiology, type of treatment (epidural blood patch (EBP), surgical or conservative), and MRI findings were collected. We conducted follow-up visits on headache characteristics and the persistence of headache >= 12 months of EBP/conservative treatment.ResultsForty-five patients with a diagnosis of IH were included (mean age of 53.0 +/- 14.9 years); 35 (77.8%) were diagnosed with spontaneous intracranial hypotension (SIH) and 10 (22.2%) with secondary IH. EBP was performed on 22 patients (48.9%). Headache was the most common symptom at presentation, in 38/45 patients (84.4%), with orthostatic features in 32 (71.1%). Forty-four patients (97.8%) had brain MRI abnormalities. Follow-up visits were conducted after 31.6 +/- 15.7 months; 28/41 (68.3%) patients reported headache during the first 12 months, and 22/41 (53.7%) >= 12 months. Headache persistence for >= 12 months was significantly lower in patients who received EBP (27.3%) compared to those who did not (63.2%) (p = 0.021). Logistic regression showed that receiving EBP was the only factor significantly associated with reduced likelihood of persistent headache for >= 12 months (OR = 0.082, 95% CI [0.007,0.903], p = 0.041). Radiological features differed significantly between patients with SIH and those with secondary etiologies.ConclusionA large proportion of patients with IH continue to experience headache beyond one year; EBP was the only predictor of headache persisting >= 12 months.
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共 26 条
[1]   Early epidural blood patch in spontaneous intracranial hypotension [J].
Berroir, S ;
Loisel, B ;
Ducros, A ;
Boukobza, M ;
Tzourio, C ;
Valade, D ;
Bousser, MG .
NEUROLOGY, 2004, 63 (10) :1950-1951
[2]   Diagnosis and Treatment of Spontaneous Intracranial Hypotension [J].
Callen, Andrew L. ;
Friedman, Deborah I. ;
Parikh, Simy ;
Rau, Jill C. ;
Schievink, Wouter I. ;
Cutsforth-Gregory, Jeremy K. ;
Amrhein, Timothy J. ;
Haight, Elena ;
Cowan, Robert P. ;
Barad, Meredith J. ;
Hah, Jennifer M. ;
Jackson, Tracy ;
Deline, Connie ;
Buchanan, Andrea J. ;
Carroll, Ian .
NEUROLOGY-CLINICAL PRACTICE, 2024, 14 (03)
[3]   Long-Term Epidural Patching Outcomes and Predictors of Benefit in Patients With Suspected CSF Leak Nonconforming to ICHD-3 Criteria [J].
Carroll, Ian ;
Han, Lichy ;
Zhang, Niushen ;
Cowan, Robert P. ;
Lanzman, Bryan ;
Hashmi, Syed ;
Barad, Meredith J. ;
Peretz, Addie ;
Moskatel, Leon ;
Ogunlaja, Oyindamola ;
Hah, Jennifer M. ;
Hindiyeh, Nada ;
Barch, Carol ;
Bozkurt, Selene ;
Hernandez-Boussard, Tina ;
Callen, Andrew L. .
NEUROLOGY, 2024, 102 (12)
[4]   The time sequence of brain MRI findings in spontaneous intracranial hypotension [J].
Chen, Shu-Ting ;
Wu, Jr-Wei ;
Wang, Yen-Feng ;
Lirng, Jiing-Feng ;
Hseu, Shu-Shya ;
Wang, Shuu-Jiun .
CEPHALALGIA, 2022, 42 (01) :12-19
[5]   Outcome of epidural blood patch for imaging-negative spontaneous intracranial hypotension [J].
Choi, So Youn ;
Seong, Minjung ;
Kim, Eung Yeop ;
Youn, Michelle Sojung ;
Cho, Soohyun ;
Jang, Hyemin ;
Lee, Mi Ji .
CEPHALALGIA, 2023, 43 (02)
[6]   Clinical Presentation, Investigation Findings, and Treatment Outcomes of Spontaneous Intracranial Hypotension Syndrome A Systematic Review and Meta-analysis [J].
D'Antona, Linda ;
Jaime Merchan, Melida Andrea ;
Vassiliou, Anna ;
Watkins, Laurence Dale ;
Davagnanam, Indran ;
Toma, Ahmed Kassem ;
Matharu, Manjit Singh .
JAMA NEUROLOGY, 2021, 78 (03) :329-337
[7]   Spontaneous intracranial hypotension: searching for the CSF leak [J].
Dobrocky, Tomas ;
Nicholson, Patrick ;
Hani, Levin ;
Mordasini, Pasquale ;
Krings, Timo ;
Brinjikji, Waleed ;
Cutsforth-Gregory, Jeremy K. ;
Schar, Ralph ;
Schankin, Christoph ;
Gralla, Jan ;
Pereira, Vitor M. ;
Raabe, Andreas ;
Farb, Richard ;
Beck, Jurgen ;
Piechowiak, Eike I. .
LANCET NEUROLOGY, 2022, 21 (04) :369-380
[8]  
Dwij M., 2023, Journal of Neurology, Neurosurgery Amp
[9]  
Psychiatry, V94, pA28
[10]   Brain MRI features of postdural puncture headache [J].
Garcia, Fernando J. Sanchez ;
Fayos, Jose Jornet ;
del Campo, Aida Pastor ;
Calatayud, Jose Emilio LLopis .
REGIONAL ANESTHESIA AND PAIN MEDICINE, 2024,