{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T12:07:21Z","timestamp":1793362041766,"version":"4.5.0"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T00:00:00Z","timestamp":1694822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian J Radiol Imaging"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Spontaneous intracranial hypotension (SICH) is the emerging cause of orthostatic headache as it has been better recognized in recent years. SICH happens due to spinal cerebrospinal fluid (CSF) leak; however, the manifestations are predominantly cranial and hence imaging in SICH includes brain and spine. There are few characteristic brain imaging features to be concerned about to diagnose SICH in patients with vague symptoms or low clinical suspicion. Spine screening is recommended in these patients to assess spinal CSF leaks. While neuroradiologists play a significant role from the time of diagnosis to treatment of SICH, there is a need for all the general radiologists to be aware of the condition. Computed tomography myelogram and digital subtraction myelogram are performed for diagnostic and therapeutic management of SICH. There is a known risk for SICH recurrence in patients with sagittal longitudinal epidural collection and hence, targeted blood patch should be used instead of blind patch. Most importantly, slow mobilization is recommended following the patch to avoid recurrence.<\/jats:p>","DOI":"10.1055\/s-0043-1774301","type":"journal-article","created":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T22:30:24Z","timestamp":1694903424000},"page":"128-138","source":"Crossref","is-referenced-by-count":5,"title":["Spontaneous Intracranial Hypotension: A Review of Neuroimaging and Current Concepts"],"prefix":"10.1055","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9501-8988","authenticated-orcid":false,"given":"Sharath Kumar","family":"Goddu Govindappa","sequence":"additional","affiliation":[{"name":"Department of Radiology, Apollo Hospitals, Sheshadripuram, Bangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7317-5800","authenticated-orcid":false,"given":"Chaitra Parameshwara","family":"Adiga","sequence":"additional","affiliation":[{"name":"Department of Radiology, Apollo Hospitals, Sheshadripuram, Bangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0554-144X","authenticated-orcid":false,"given":"Savith","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Radiology, Apollo Hospitals, Sheshadripuram, Bangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmikanth N.","family":"Goolahally","sequence":"additional","affiliation":[{"name":"Department of Radiology, Apollo Hospitals, Sheshadripuram, Bangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujit","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Neurology, Apollo Hospitals, Sheshadripuram, Bangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,9,16]]},"reference":[{"issue":"12","key":"ref1","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1212\/WNL.56.12.1746","article-title":"The Monro-Kellie hypothesis: applications in CSF volume depletion","volume":"56","author":"B Mokri","year":"2001","journal-title":"Neurology"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/0333102417738202","article-title":"Headache classification committee of the international headache society (IHS) the international classification of headache disorders, 3rd edition","volume":"38","year":"2018","journal-title":"Cephalalgia"},{"key":"ref6","first-page":"480","article-title":"Spontaneous intracranial hypotension","volume":"117","author":"H Urbach","year":"2020","journal-title":"Dtsch Arztebl Int"},{"key":"ref7","first-page":"158","volume-title":"Intracranial Hypotension","author":"D Kim","year":"2019"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.nic.2019.07.006","article-title":"Spontaneous intracranial hypotension: pathogenesis, diagnosis, and treatment","volume":"29","author":"P G Kranz","year":"2019","journal-title":"Neuroimaging Clin N Am"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"e181","DOI":"10.1016\/j.crad.2021.11.007","article-title":"Spontaneous intracranial hypotension: the role of radiology in diagnosis and management","volume":"77","author":"L Carlton Jones","year":"2022","journal-title":"Clin Radiol"},{"issue":"04","key":"ref10","first-page":"745","article-title":"Spontaneous intracranial hypotension: a systematic imaging approach for CSF leak localization and management based on MRI and digital subtraction myelography","volume":"40","author":"R I Farb","year":"2019","journal-title":"Am J Neuroradiol"},{"issue":"11","key":"ref11","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1007\/s00234-021-02766-z","article-title":"Spontaneous intracranial hypotension: diagnostic and therapeutic workup","volume":"63","author":"N Luetzen","year":"2021","journal-title":"Neuroradiology"},{"issue":"07","key":"ref12","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.3174\/ajnr.A7548","article-title":"Spontaneous spinal CSF leaks stratified by age, body mass index, and spinal level","volume":"43","author":"M D Mamlouk","year":"2022","journal-title":"Am J Neuroradiol"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"292","DOI":"10.2214\/AJR.22.27485","article-title":"Algorithmic multimodality approach to diagnosis and treatment of spinal CSF leak and venous fistula in patients with spontaneous intracranial hypotension","volume":"219","author":"A L Callen","year":"2022","journal-title":"Am J Roentgenol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"842","DOI":"10.12659\/PJR.904433","article-title":"Diagnostic imaging and clinical features of intracranial hypotension \u2013 review of literature","volume":"82","author":"M Michali-Stolarska","year":"2017","journal-title":"Pol J Radiol"},{"issue":"07","key":"ref15","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1111\/head.14584","article-title":"A causative role for remote dural puncture and resultant arachnoid bleb in new daily persistent headache: a case report","volume":"63","author":"A L Callen","year":"2023","journal-title":"Headache"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/S0140-6736(17)32451-0","article-title":"Atraumatic versus conventional lumbar puncture needles: a systematic review and meta-analysis","volume":"391","author":"S Nath","year":"2018","journal-title":"Lancet"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.2214\/AJR.18.20369","article-title":"MRI findings of spontaneous intracranial hypotension: usefulness of straight sinus distention","volume":"212","author":"S C Kim","year":"2019","journal-title":"Am J Roentgenol"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s00062-022-01210-w","article-title":"Teaching neuroimages: dynamic digital subtraction myelography discloses a ventral CSF leak in a patient with upper limb amyotrophy","volume":"33","author":"N L\u00fctzen","year":"2023","journal-title":"Clin Neuroradiol"},{"issue":"08","key":"ref19","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1590\/0004-282x20180070","article-title":"Spontaneous intracranial hypotension and its complications","volume":"76","author":"M MV Gir\u00e3o","year":"2018","journal-title":"Arq Neuropsiquiatr"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"2","DOI":"10.3174\/ajnr.A7721","article-title":"The Monro-Kellie doctrine: a review and call for revision","volume":"44","author":"J C Benson","year":"2023","journal-title":"Am J Neuroradiol"},{"issue":"05","key":"ref21","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1007\/s00234-023-03140-x","article-title":"Correction to: Unusual neuroimaging findings in spontaneous intracranial hypotension","volume":"65","author":"A L Callen","year":"2023","journal-title":"Neuroradiology"},{"issue":"08","key":"ref22","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.3174\/ajnr.A6637","article-title":"Spontaneous intracranial hypotension: atypical radiologic appearances, imaging mimickers, and clinical look-alikes","volume":"41","author":"K M Bond","year":"2020","journal-title":"Am J Neuroradiol"},{"issue":"06","key":"ref23","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.3171\/2021.6.JNS211010","article-title":"Differentiation of Chiari malformation type 1 and spontaneous intracranial hypotension using objective measurements of midbrain sagging","volume":"136","author":"J L Houk","year":"2021","journal-title":"J Neurosurg"},{"issue":"03","key":"ref24","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1148\/radiol.2018180732","article-title":"Cryptogenic cerebrospinal fluid leaks in spontaneous intracranial hypotension: Role of dynamic CT myelography","volume":"289","author":"T Dobrocky","year":"2018","journal-title":"Radiology"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"8","DOI":"10.2214\/AJR.15.14884","article-title":"Myelographic techniques for the detection of spinal CSF leaks in spontaneous intracranial hypotension","volume":"206","author":"P G Kranz","year":"2016","journal-title":"Am J Roentgenol"},{"issue":"08","key":"ref26","doi-asserted-by":"crossref","first-page":"994","DOI":"10.3174\/ajnr.A7927","article-title":"Resisted inspiration improves visualization of CSF-venous fistulas in spontaneous intracranial hypotension","volume":"44","author":"P G Kranz","year":"2023","journal-title":"Am J Neuroradiol"},{"issue":"24","key":"ref27","doi-asserted-by":"crossref","first-page":"2445","DOI":"10.1212\/WNL.0000000000001697","article-title":"False localizing sign of cervico-thoracic CSF leak in spontaneous intracranial hypotension","volume":"84","author":"W I Schievink","year":"2015","journal-title":"Neurology"},{"issue":"02","key":"ref28","doi-asserted-by":"crossref","first-page":"459","DOI":"10.2214\/AJR.09.3289","article-title":"Spinal imaging findings in spontaneous intracranial hypotension","volume":"195","author":"J H Medina","year":"2010","journal-title":"Am J Roentgenol"},{"issue":"02","key":"ref29","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s00234-022-03079-5","article-title":"Spontaneous intracranial hypotension: updates from diagnosis to treatment","volume":"65","author":"P J Farnsworth","year":"2023","journal-title":"Neuroradiology"},{"issue":"02","key":"ref30","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1212\/CPJ.0000000000000550","article-title":"Rebound high-pressure headache after treatment of spontaneous intracranial hypotension: MRV study","volume":"9","author":"W I Schievink","year":"2019","journal-title":"Neurol Clin Pract"}],"container-title":["Indian Journal of Radiology and Imaging"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1774301.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T23:42:10Z","timestamp":1702683730000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1774301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,16]]},"references-count":27,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2023,12,15]]},"published-print":{"date-parts":[[2024,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1774301","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0971-3026","1998-3808"],"issn-type":[{"value":"0971-3026","type":"print"},{"value":"1998-3808","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,16]]}}}