ReviewDeutsches Arzteblatt international2020
Spontaneous Intracranial Hypotension.
Review in Deutsches Arzteblatt international, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Endovascular embolization of cerebrospinal fluid-venous fistula: a comprehensive systematic review on its efficacy and safety for the management of spontaneous intracranial hypotension.Neurosurgical review · 2024Pooled it
- Efficacy of Epidural Blood Patching or Surgery in Spontaneous Intracranial Hypotension: A Systematic Review and Evidence Map.AJNR. American journal of neuroradiology · 2023Pooled it
- Brain distortion and cerebrospinal fluid shifts in spontaneous intracranial hypotension.Fluids and barriers of the CNS · 2026Article
- Prediction for occurrence of subdural hematoma following spontaneous intracranial hypotension: a large cohort of 575 adults in a single center from 2023 to 2024.The journal of headache and pain · 2026Article
- Resolution of pachymeningeal enhancement is a radiographic marker for effective treatment of spontaneous intracranial hypotension: patient series.Journal of neurosurgery. Case lessons · 2026Article
- Standardized spinal MRI protocol: diagnosing spontaneous intracranial hypotension and correlating with brain MRI.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Associations of Refractory Spontaneous Intracranial Hypotension and Chronic Subdural Hematoma with Factor XIII Deficiency: A Case Report.Asian journal of neurosurgery · 2025Article
- Percutaneous CT-guided Onyx embolization of CSF-venous fistula: illustrative case.Journal of neurosurgery. Case lessons · 2025Article
- Incidence of spontaneous intracranial hypotension in Olmsted County, Minnesota: 2019-2021.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- The impact of CSF venous fistula embolization on patient's quality of life, a longitudinal clinical-radiological exploration.The journal of headache and pain · 2025Article
- Three Fluoroscopy-Guided Epidural Blood Patches for the Management of Spontaneous Intracranial Hypotension.Cureus · 2025Article
- Diagnosis and Management of Spontaneous Intracranial Hypotension Due to a CSF Leak: A Case of Spontaneous Recovery.Cureus · 2025Article
- Ultrasound-based measurement of optic nerve sheath to evaluate increased intracranial pressure on patients in emergency department.Frontiers in neurology · 2025Article
- Spontaneous Intracranial Hypotension and Dural Ectasia in Marfan Syndrome: An Illustrative Case Successfully Treated with Steroid Therapy and Literature Review.Brain sciences · 2024Article
- Deep learning-based reconstruction for 3-dimensional heavily T2-weighted fat-saturated magnetic resonance (MR) myelography in epidural fluid detection: image quality and diagnostic performance.Quantitative imaging in medicine and surgery · 2024Article
- A Low-Volume Epidural Blood Patch for the Treatment of Spontaneous Intracranial Hypotension: A Case Report.Cureus · 2024Article
- Spontaneous Intracranial Hypotension: Case Report and Update on Diagnosis and Treatment.Diagnostics (Basel, Switzerland) · 2024Article
- Spontaneous Intracranial Hypotension: A Review of Neuroimaging and Current Concepts.The Indian journal of radiology & imaging · 2024Review
- Cerebral Superficial Siderosis : Etiology, Neuroradiological Features and Clinical Findings.Clinical neuroradiology · 2023Review
- A False Pituitary Tumor.JCEM case reports · 2023Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSpontaneous intracranial hypotension (SIH) is an underdiagnosed disease. Its incidence is estimated at 5 per 100 000 persons per year.
methodsThis review is based on a selective literature search in PubMed covering the years 2000-2019, as well as on the authors' personal experience.
resultsThe diagnostic and therapeutic methods discussed here are supported by level 4 evidence. SIH is caused by spinal leakage of cerebrospinal fluid (CSF) out of ventral dural tears or nerve root diverticula, or, in 2-5% of cases, through a fistula leading directly into the periradicular veins (CSF-venous fistula). In half of all patients, no CSF leak is demonstrable. A low CSF opening pressure on lumbar puncture is present in only one-third of patients; imaging studies are thus needed to confirm and localize a spinal CSF leak. Half of all patients in whom myelographic computed tomography (CT) reveals contrast medium reaching the epidural space have ventral dural tears, which tend to be located at upper thoracic spinal levels. Epidural blood patches applied under fluoroscopic or CT guidance can seal the CSF leak in 30-70% of patients, but 90% of patients with ventral dural tears will need operative closure. Some patients who have no visible epidural contrast medium on CT presumably do not have SIH, while others do, in fact, have a CSF leak from a diverticulum or a CSF-venous fistula and will need to have the site of the leak demonstrated with the aid of further studies, such as dynamic (subtraction) myelography in the lateral decubitus position.
conclusionThe management of patients with SIH calls for complementary imaging studies to demonstrate the causative spinal CSF leak. Often, successful treatment requires surgical closure of the leak. In view of the sparse evidence available to date, controlled studies should be performed.
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Registered trials
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