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Several factors may influence the outcome, with symptom duration probably the most modifiable variable.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients with closure of spinal CSF leaks between September 2020 and March 2023 and a follow-up period of 6\u00a0months were included in this retrospective single-center study. Pre- and postoperative scores for impact of headaches (Headache Impact Test, HIT-6) and quality of life (QoL, EQ-5D-5L) were systematically collected. Multiple regression modelling and subgroup analyses for different symptom durations and comorbidities were performed for these outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>One hundred patients (61% female, median age 43.5\u00a0years) were included. Six months postoperatively, there was significant improvement in headache impact (HIT-6: 66 (IQR 62\u201369) to 52 (IQR 40\u201361, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and QoL (EQ-5D-5L VAS: 40 (IQR 30\u201360) to 79 (IQR 60\u201390); EQ-5D-5L Index: 0.67 (IQR 0.35\u20130.8) to 0.91 (IQR 0.8\u20130.94, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, respectively). Subgroup analysis for a symptom duration above (74%) and below 90\u00a0days (26%) and comorbidity, as well as multiple regression analysis, revealed a trend in favor of early treatment and lower comorbidity. However, even after a prolonged symptom duration, improvements were significant.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>As patients with shorter symptom duration show a trend for a better outcome, our results promote a timely diagnosis and treatment in SIH patients. However, a significant postoperative improvement can still be expected even after a prolonged symptom duration.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00415-024-12242-2","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T20:02:01Z","timestamp":1708977721000},"page":"2776-2786","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Don\u2019t delay, but don\u2019t despair: symptom duration, comorbidity and outcome after closure of spinal cerebrospinal fluid leaks"],"prefix":"10.1007","volume":"271","author":[{"given":"Florian","family":"Volz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"El Rahal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Fung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukesch","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"L\u00fctzen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"Urbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7687-6098","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Beck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,26]]},"reference":[{"key":"12242_CR1","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1001\/jamaneurol.2020.4799","volume":"78","author":"L D\u2019Antona","year":"2021","unstructured":"D\u2019Antona L, Jaime Merchan MA, Vassiliou A et al (2021) Clinical presentation, investigation findings, and treatment outcomes of spontaneous intracranial hypotension syndrome: a systematic review and meta-analysis. 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W. is a Fellow of the Margarete von Wrangell program that is sponsored by the Ministry of Research, Science and Arts Baden-W\u00fcrttemberg, Germany. A.E.R. received a scholarship grant from the Nuovo-Soldati oncology research foundation. All authors have no personal, financial, or institutional interest in any of the materials or devices described in this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The study was performed in line with the principles of the Declaration of Helsinki and approved by the local Ethics Committee (22-1512-S1-retro).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All patients provided informed consent for evaluating and publishing the PROM data.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}