{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T10:23:10Z","timestamp":1777976590913,"version":"3.51.4"},"reference-count":10,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Spontaneous intracranial hypotension is an important cause of headaches and an underlying spinal CSF leak can be demonstrated in most patients. Whether CSF leaks at the level of the skull base can cause spontaneous intracranial hypotension remains a matter of controversy. The authors' aim was to examine the frequency of skull base CSF leaks as the cause of spontaneous intracranial hypotension.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Demographic, clinical, and radiological data were collected from a consecutive group of patients evaluated for spontaneous intracranial hypotension during a 9-year period.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Among 273 patients who met the diagnostic criteria for spontaneous intracranial hypotension and 42 who did not, not a single instance of CSF leak at the skull base was encountered. Clear nasal drainage was reported by 41 patients, but a diagnosis of CSF rhinorrhea could not be established. Four patients underwent exploratory surgery for presumed CSF rhinorrhea. In addition, the authors treated 3 patients who had a postoperative CSF leak at the skull base following the resection of a cerebellopontine angle tumor and developed orthostatic headaches; spinal imaging, however, demonstrated the presence of a spinal source of CSF leakage in all 3 patients.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>There is no evidence for an association between spontaneous intracranial hypotension and CSF leaks at the level of the skull base. Moreover, the authors' study suggests that a spinal source for CSF leakage should even be suspected in patients with orthostatic headaches who have a documented skull base CSF leak.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.12.jns111474","type":"journal-article","created":{"date-parts":[[2012,1,20]],"date-time":"2012-01-20T15:28:40Z","timestamp":1327073320000},"page":"749-754","source":"Crossref","is-referenced-by-count":82,"title":["Lack of causal association between spontaneous intracranial hypotension and cranial cerebrospinal fluid leaks"],"prefix":"10.3171","volume":"116","author":[{"given":"Wouter I.","family":"Schievink","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc S.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"House Clinic, Los Angeles, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Marcel","family":"Maya","sequence":"additional","affiliation":[{"name":"Radiology, Cedars-Sinai Medical Center;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franklin G.","family":"Moser","sequence":"additional","affiliation":[{"name":"Radiology, Cedars-Sinai Medical Center;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd D.","family":"Rozen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Geisinger Specialty Clinic, Wilkes-Barre, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns111474","series-title":"Headache","first-page":"213","article-title":"The Sinus, Allergy and Migraine Study (SAMS)","volume":"47","author":"Eross","year":"2007"},{"key":"b2-jns111474","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1116","article-title":"Cranial autonomic symptoms in migraine: characteristics and comparison with cluster headache","volume":"80","author":"Lai","year":"2009"},{"key":"b3-jns111474","series-title":"J Neurol Sci","first-page":"1","article-title":"The pathophysiology of lumbar puncture headache","volume":"192","author":"Levine","year":"2001"},{"key":"b4-jns111474","series-title":"Wolff's Headache and Other Head Pain","first-page":"379","article-title":"Trigeminal autonomic cephalalgias: diagnosis and management","author":"Matharu","year":"2008"},{"key":"b5-jns111474","series-title":"Wolff's Headache and Other Head Pain","first-page":"513","article-title":"Headache associated with abnormalities in intracranial structure or function: low-cerebrospinal-fluid-pressure headache","author":"Mokri","year":"2008"},{"key":"b6-jns111474","series-title":"Headache","first-page":"85","article-title":"A history of cigarette smoking is associated with the development of cranial autonomic symptoms with migraine headaches","volume":"51","author":"Rozen","year":"2011"},{"key":"b7-jns111474","series-title":"JAMA","first-page":"2286","article-title":"Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension","volume":"295","author":"Schievink","year":"2006"},{"key":"b8-jns111474","series-title":"J Neurosurg","first-page":"113","article-title":"Frequency of intracranial aneurysms in patients with spontaneous intracranial hypotension. Clinical article","volume":"115","author":"Schievink","year":"2011"},{"key":"b9-jns111474","series-title":"AJNR Am J Neuroradiol","first-page":"853","article-title":"Diagnostic criteria for spontaneous spinal CSF leaks and intracranial hypotension","volume":"29","author":"Schievink","year":"2008"},{"key":"b10-jns111474","series-title":"J Neurosurg","first-page":"521","article-title":"Spontaneous spinal cerebrospinal fluid leak as a cause of coma after craniotomy for clipping of an unruptured intracranial aneurysm. Case report","volume":"110","author":"Schievink","year":"2009"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/4\/article-p749.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/4\/article-p749.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/4\/article-p749.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T01:15:03Z","timestamp":1679879703000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/4\/article-p749.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2012,4]]},"references-count":10,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2011.12.jns111474","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,4]]}}}