{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T04:33:02Z","timestamp":1777955582342,"version":"3.51.4"},"reference-count":70,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Laryngorhinootologie"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die spontane intrakranielle Hypotension (SIH) ist ein unterdiagnostiziertes Krankheitsbild, das jedoch aufgrund neuer wissenschaftlicher Erkenntnisse zunehmend Aufmerksamkeit erf\u00e4hrt. Die Diagnosestellung kann durch ein breites klinisches Erscheinungsbild und Fallstricke in der Bildgebung verz\u00f6gert werden. Daraus resultiert eine hohe k\u00f6rperliche Beeintr\u00e4chtigung f\u00fcr die Patienten, einschlie\u00dflich sozialer und psychischer Folgen sowie Langzeitsch\u00e4den bei prolongierter Diagnostik und Therapie.<\/jats:p>\n                  <jats:p>Basierend auf einer selektiven Literaturrecherche auf PubMed mit Einschluss aller Arbeiten zwischen 1990 und 2023 sowie der klinischen Erfahrung aus der Arbeit der Autoren in einem CSF-Zentrum.<\/jats:p>\n                  <jats:p>SIH betrifft meist Frauen im mittleren Alter, Leitsymptom ist dabei der lageabh\u00e4ngige orthostatische Kopfschmerz. Daneben gibt es ein breites Spektrum weiterer m\u00f6glicher Symptome, die sich mit anderen Krankheitsbildern \u00fcberlappen k\u00f6nnen und dementsprechend die Diagnosestellung erschweren. Der urs\u00e4chliche spinale Liquorverlust l\u00e4sst sich in drei Haupttypen unterteilen: das ventrale (Typ 1) und laterale (Typ 2) Duraleck sowie die Liquor-Vene-Fistel (Typ 3). Die Diagnostik kann \u00fcber eine zweistufige Aufarbeitung erfolgen. Im ersten Schritt liefert die nicht invasive MRT von Kopf und Wirbels\u00e4ule Hinweise auf das Vorliegen einer SIH. Der zweite Schritt mittels gezielter Myelografie kann den genauen Ort des Liquoraustritts identifizieren und eine gezielte Behandlung erm\u00f6glichen (operativ oder interventionell). Eine intrathekale Druckmessung oder die intrathekale Gabe von Gadolinium ist dabei zur Prim\u00e4rdiagnostik nicht mehr notwendig. Ernstzunehmende Komplikationen im Verlauf der Krankheit bestehen z.B. in raumfordernden Subduralh\u00e4matomen, der superfiziellen Siderose und Symptomen im Rahmen eines \u201ebrain sagging\u201c, was zu Fehlinterpretationen f\u00fchren kann. Die Therapie besteht im Verschluss des Duralecks bzw. der Liquorfistel. Auch nach erfolgreicher Therapie k\u00f6nnen Rezidive auftreten, was die Wichtigkeit einer klinischen Nachsorgeuntersuchung einschlie\u00dflich Follow-Up-MRT betont und den chronischen Charakter der Krankheit unterstreicht. Diese Arbeit liefert eine \u00dcbersicht \u00fcber den diagnostischen Work-Up von Patienten mit Verdacht auf SIH und neue Entwicklungen in Bildgebung und Therapie.<\/jats:p>","DOI":"10.1055\/a-2724-7080","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:34:40Z","timestamp":1777934080000},"page":"286-296","source":"Crossref","is-referenced-by-count":0,"title":["Spontane intrakranielle Hypotension \u2013 eine spinale Erkrankung"],"prefix":"10.1055","volume":"105","author":[{"given":"Charlotte","family":"Zander","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Freiburg","place":["Freiburg"],"department":["Klinik f\u00fcr Neuroradiologie"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Wolf","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Freiburg","place":["Freiburg"],"department":["Klinik f\u00fcr 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