{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T02:08:36Z","timestamp":1772849316331,"version":"3.50.1"},"reference-count":27,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"Background:<\/jats:title>We previously found the usefulness of dural sac shrinkage signs (DSSSs), which are the anterior shift of the spinal cord and dura mater behind the cord, detected by magnetic resonance imaging (MRI) at the thoracic level for the diagnosis of spontaneous intracranial hypotension (IH). This is a retrospective survey on the usefulness of DSSSs for the early detection of iatrogenic IH caused by overdrainage through a lumboperitoneal shunt (LPS) for patients with idiopathic normal pressure hydrocephalus (INPH).<\/jats:p><\/jats:sec>Methods:<\/jats:title>Forty-five INPH patients had an LPS using a pressure programmable valve equipped with an anti-siphon device.<\/jats:p><\/jats:sec>Results:<\/jats:title>Nine patients complained of orthostatic headache after the LPS, indicating IH due to overdrainage, which persisted for more than a week in three patients and 2\u20137days in six patients. The headache was transient\/ nonorthostatic in ten patients and absent in 26 patients. The DSSSs and accompanying enlargement of the venous plexus were observed in all three patients with prolonged orthostatic headaches. Only the anterior shift of the dura mater was observed in 1 (4%) among 25 patients who had short-term orthostatic headache, transient\/ nonorthostatic headache, or absent headache, and underwent spinal MRI. A patient with prolonged severe orthostatic headache with both DSSSs eventually developed intracranial subdural effusion and underwent tandem valve surgery, which provided a quick improvement of symptoms. The DSSSs on thoracic MRI also disappeared promptly.<\/jats:p><\/jats:sec>Conclusion:<\/jats:title>DSSSs may serve as objective signs for the diagnosis of IH due to overdrainage through an LPS for INPH.<\/jats:p><\/jats:sec>","DOI":"10.25259\/sni_291_2022","type":"journal-article","created":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T08:32:22Z","timestamp":1656059542000},"page":"269","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Dural sac shrinkage signs on spinal magnetic resonance imaging indicate overdrainage after lumboperitoneal shunt for idiopathic normal pressure hydrocephalus"],"prefix":"10.25259","volume":"13","author":[{"given":"Takashi","family":"Kawahara","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Atsuchi Neurosurgical Hospital,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masamichi","family":"Atsuchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Atsuchi Neurosurgical Hospital,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazunori","family":"Arita","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kagoshima University, Kagoshima City, Japan,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shingo","family":"Fujio","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kagoshima University, Kagoshima City, Japan,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nayuta","family":"Higa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kagoshima University, Kagoshima City, Japan,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"FM","family":"Moinuddin","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Yoshimoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kyushu University, Higashi-ku, Hukuoka, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryosuke","family":"Hanaya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kagoshima University, Kagoshima City, Japan,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"10.25259\/SNI_291_2022\/ref-1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1159\/000314052","article-title":"Novel method for controlling cerebrospinal fluid flow and intracranial pressure by use of a tandem shunt valve system","volume":"46","author":"Aihara","year":"2010","journal-title":"Pediatr Neurosurg"},{"key":"10.25259\/SNI_291_2022\/ref-2","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/BF00277653","article-title":"Overdrainage and shunt technology. 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