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To depict the accurate diagnosis can be demanding; especially the detection of CSF\u2013venous fistulas poses many challenges. Potential dynamic biomarkers have been identified through non-invasive phase-contrast MRI in a limited subset of SIH patients with evidence of spinal longitudinal extradural collection. This study aimed to explore these biomarkers related to spinal cord motion and CSF velocities in a broader SIH cohort.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective, monocentric pooled-data analysis was conducted of patients suspected to suffer from SIH who underwent phase-contrast MRI for spinal cord and CSF velocity measurements at segment C2\/C3 referred to a tertiary center between February 2022 and June 2023. Velocity ranges (mm\/s), total displacement (mm), and further derivatives were assessed and compared to data from the database of 70 healthy controls.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In 117 patients, a leak was located (54% ventral leak, 20% lateral leak, 20% CSF\u2013venous fistulas, 6% sacral leaks). SIH patients showed larger spinal cord and CSF velocities than healthy controls: e.g., velocity range 7.6\u2009\u00b1\u20093\u00a0mm\/s vs. 5.6\u2009\u00b1\u20091.4\u00a0mm\/s, 56\u2009\u00b1\u200921\u00a0mm\/s vs. 42\u2009\u00b1\u200910\u00a0mm\/s, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, respectively. Patients with lateral leaks and CSF\u2013venous fistulas exhibited an exceptionally heightened level of spinal cord motion (e.g., velocity range 8.4\u2009\u00b1\u20093.3\u00a0mm\/s; 8.2\u2009\u00b1\u20093.1\u00a0mm\/s vs. 5.6\u2009\u00b1\u20091.4\u00a0mm\/s, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, respectively).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Phase-contrast MRI might become a valuable tool for SIH diagnosis, especially in patients with CSF\u2013venous fistulas without evidence of spinal extradural fluid collection.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00415-024-12365-6","type":"journal-article","created":{"date-parts":[[2024,4,21]],"date-time":"2024-04-21T08:01:17Z","timestamp":1713686477000},"page":"4336-4347","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Non-invasive biomarkers for spontaneous intracranial hypotension (SIH) through phase-contrast MRI"],"prefix":"10.1007","volume":"271","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1468-3634","authenticated-orcid":false,"given":"Katharina","family":"Wolf","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Volz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niklas","family":"L\u00fctzen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hansjoerg","family":"Mast","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Reisert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir El","family":"Rahal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Fung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mukesch J.","family":"Shah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"Beck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Horst","family":"Urbach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,21]]},"reference":[{"issue":"4","key":"12365_CR1","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/S1474-4422(21)00423-3","volume":"21","author":"T Dobrocky","year":"2022","unstructured":"Dobrocky T, Nicholson P, H\u00e4ni L et al (2022) Spontaneous intracranial hypotension: searching for the CSF leak. 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