{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:50:17Z","timestamp":1785891017778,"version":"3.56.0"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,8,3]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Spontaneous intracranial hypotension (SIH) is typically recognized by orthostatic headache and characteristic neuroimaging findings such as brain sagging and dural enhancement, but atypical manifestations and long-term sequelae remain underreported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors present 5 cases that illustrate uncommon SIH presentations and complications, including reversible cerebral vasoconstriction syndrome, sinus vein thrombosis, ventral spinal cord herniation, thoracic meningocele, secondary Arnold-Chiari malformation type I, and superficial siderosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>SIH may present with diverse complications beyond orthostatic headache; awareness and follow-up imaging are important for timely diagnosis and management.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26236\">https:\/\/thejns.org\/doi\/10.3171\/CASE26236<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26236","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:01:37Z","timestamp":1785888097000},"source":"Crossref","is-referenced-by-count":0,"title":["Atypical presentations and long-term sequelae of spontaneous intracranial hypotension: illustrative cases"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3586-2079","authenticated-orcid":true,"given":"Danial","family":"Nasiri","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levin","family":"H\u00e4ni","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis P. R.","family":"Terrapon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Lutz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6066-3549","authenticated-orcid":true,"given":"Johannes","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Dorn","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2788-4793","authenticated-orcid":true,"given":"Christine","family":"Roten-Joss","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aude","family":"Eckert","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Raabe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner J.","family":"Z\u2019Graggen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern"},{"name":"Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eike I.","family":"Piechowiak","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph T.","family":"Sch\u00e4r","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Dobrocky","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"J Patient Rep Outcomes","first-page":"82","article-title":"Patient experience of spontaneous intracranial hypotension (SIH): qualitative interviews for concept elicitation","volume":"7","author":"Amrhein","year":"2023","unstructured":"Amrhein TJMcFatrich MEhle KPatient experience of spontaneous intracranial hypotension (SIH): qualitative interviews for concept elicitation. 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Lancet Neurol. 2022;21(4):369-380. doi:10.1016\/S1474-4422(21)00423-3"},{"issue":"19","key":"bib4","series-title":"Neurology","first-page":"e1964","article-title":"Long-term risks of persistent ventral spinal CSF leaks in SIH: superficial siderosis and bibrachial amyotrophy","volume":"97","author":"Schievink","year":"2021","unstructured":"Schievink WIMaya MMoser FNu\u00f1o M.Long-term risks of persistent ventral spinal CSF leaks in SIH: superficial siderosis and bibrachial amyotrophy. Neurology. 2021;97(19):e1964-e1970. doi:10.1212\/WNL.0000000000012786"},{"issue":"6","key":"bib5","series-title":"Neurology","first-page":"e55","article-title":"Pearls & Oy-sters: spontaneous intracranial hypotension and posterior reversible encephalopathy syndrome","volume":"86","author":"Santillan","year":"2016","unstructured":"Santillan AAamodt WBhavaraju-Sanka R.Pearls & Oy-sters: spontaneous intracranial hypotension and posterior reversible encephalopathy syndrome. 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