{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:07:00Z","timestamp":1785236820277,"version":"3.55.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Neurohospitalist"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Spontaneous intracranial hypotension (SIH) results from cerebrospinal fluid (CSF) leakage due to spinal dural tears or CSF\u2013venous fistulas. Orthostatic headache is the hallmark presentation, though severe downward displacement of the brainstem may lead to altered consciousness or coma. Definitive treatments include targeted epidural blood patches, venous embolization, or surgical repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This article reviews the role of the Trendelenburg position as a temporizing measure in the acute management of SIH. We describe the correct technique, physiologic rationale, and practical considerations for its application, with attention to both therapeutic and diagnostic utility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Positioning the patient with the feet elevated above the head can reduce brain sag and provide short-term symptomatic relief while awaiting definitive treatment. Although the Trendelenburg position is widely used in practice, supporting evidence remains limited, and clinicians must be aware of its benefits, indications, and inherent limitations. Its appropriate application may assist in stabilizing patients with acute or severe SIH, particularly those with impaired consciousness, until more definitive interventions are pursued.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19418744251399726","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T05:25:56Z","timestamp":1763357156000},"page":"280-285","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Role of Trendelenburg Positioning for the Acute Symptomatic Management of Spontaneous Intracranial Hypotension"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5670-6537","authenticated-orcid":false,"given":"Tony","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7826-4362","authenticated-orcid":false,"given":"Sara J.","family":"Hooshmand","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Nathaniel P.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1669-7784","authenticated-orcid":false,"given":"David O.","family":"Sohutskay","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Toledano","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek W.","family":"Stitt","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan D.","family":"Carabenciov","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay A.","family":"Madhavan","sequence":"additional","affiliation":[{"name":"Mayo Clinic College of Medicine & Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy K.","family":"Cutsforth-Gregory","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2827-0507","authenticated-orcid":false,"given":"Rafid","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,16]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2101561"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00423-3"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A8308"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000005477"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1067\/msy.1999.98735"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1152\/advan.00187.2017"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.760081"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003404"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2024.10.001"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3182642327"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001937"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2009.02913.x"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED-D-14-00141"},{"issue":"3","key":"e_1_3_3_15_2","first-page":"E465","article-title":"Reversal of progressive conscious disturbance with epidural blood patch for cerebrospinal fluid leakage at C2 level","volume":"20","author":"Lai YC","year":"2017","unstructured":"Lai YC, Chia YY, Lien WH. Reversal of progressive conscious disturbance with epidural blood patch for cerebrospinal fluid leakage at C2 level. Pain Physician. 2017;20(3):E465-E468.","journal-title":"Pain Physician"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2025.02.006"}],"container-title":["The Neurohospitalist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19418744251399726","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19418744251399726","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19418744251399726","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T10:57:24Z","timestamp":1785236244000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19418744251399726"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,16]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/19418744251399726"],"URL":"https:\/\/doi.org\/10.1177\/19418744251399726","relation":{},"ISSN":["1941-8744","1941-8752"],"issn-type":[{"value":"1941-8744","type":"print"},{"value":"1941-8752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,16]]}}}