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Medical records and imaging findings were reviewed. The outcome of treatment responses to epidural blood patches and risks of subdural hematoma were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 442 patients with spontaneous intracranial hypotension (165\u2009males, 277 females) were included in the analysis. Males were more likely to have a delayed (&gt;30\u2009days) initial presentation than females (32.1% [53\/165] vs. 19.9% [55\/277],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), and males were less likely to have nausea (55.8% [92\/165] vs. 67.1% [186\/277],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016), vomiting (43.0% [71\/165] vs. 54.2% [150\/277],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024), photophobia (9.7% [16\/165] vs. 17.0% [47\/277],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034), and tinnitus (26.7% [44\/165] vs. 39.7% [110\/277],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) compared with females despite comparable radiologic findings. Among the 374 patients treated with epidural blood patches, males were more likely to be nonresponders to the first epidural blood patch (58.0% [80\/138] vs. 39.0% [92\/236], OR\u2009=\u20092.2, 95% CI\u2009=\u20091.4\u20133.3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Males were at a higher risk of having subdural hematoma (29.7% [49\/165] vs. 10.8% [30\/277], OR\u2009=\u20093.5, 95% CI\u2009=\u20092.1\u20135.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Among patients with subdural hematoma, males had greater thickness (12.8\u2009\u00b1\u20094.3 vs. 8.1\u2009\u00b1\u20095.9\u2009mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and were more likely to receive surgical drainage (55.1% [27\/49] vs. 10.0% [3\/30], OR\u2009=\u200911.0, 95% CI\u2009=\u20093.0\u201341.3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) than females.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the present study, spontaneous intracranial hypotension in males was characterized by a delayed presentation, poorer response to the first epidural blood patch, and a higher risk of subdural hematoma. Caution should be exercised in the management of males with spontaneous intracranial hypotension. The generalizability of the findings needs to be further confirmed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14816","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T07:49:50Z","timestamp":1725263390000},"page":"1298-1308","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Sex differences in the clinical manifestations and treatment outcomes in a large cohort of spontaneous intracranial hypotension"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1985-8352","authenticated-orcid":false,"given":"Po\u2010Tso","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Neurology Neurological Institute, Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"College of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Institute of Brain Science National Yang Ming Chiao Tung University  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