Evidence map›Paper›PMID 36336758›Full record

ReviewNeuroradiology2023

Spontaneous intracranial hypotension: updates from diagnosis to treatment.

Paul J Farnsworth, Ajay A Madhavan, Jared T Verdoorn, Darya P Shlapak, Derek R Johnson, Jeremy K Cutsforth-Gregory, Waleed Brinjikji, Vance T Lehman

Abstract readReview
PubMed Publisher
In one paragraph

Review in Neuroradiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Risk Reduction of Recurrent Cerebrospinal Fluid Leaks With Postoperative Intracranial Pressure Management: A Systematic Review.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
    Pooled it
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  4. Spontaneous intracranial hypotension: A stepwise diagnostic and therapeutic workflow from a tertiary referral center.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
  5. Article
  6. A technique to localize posteriorly located spinal dural leaks associated with spontaneous intracranial hypotension: Dorsal-decubitus dynamic CT myelography.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026
    Article
  7. Article
  8. Updated ultrafast dynamic computed tomography myelography technique for cerebrospinal fluid leaks.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Paul J FarnsworthDepartment of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA. farnsworth.paul@mayo.edu.ORCID http://orcid.org/0000-0002-3955-6722
Ajay A MadhavanDepartment of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
Jared T VerdoornDepartment of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
Darya P ShlapakDepartment of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
Derek R JohnsonDepartment of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
Jeremy K Cutsforth-GregoryDepartment of Neurology, Mayo Clinic, Rochester, MN, USA.
Waleed BrinjikjiDepartment of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
Vance T LehmanDepartment of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Spontaneous intracranial hypotension (SIH) is caused by spinal cerebrospinal fluid (CSF) leaks, which result in continued loss of CSF volume and multiple debilitating clinical manifestations. The estimated annual incidence of SIH is 5/100,000. Diagnostic methods have evolved in recent years due to improved understanding of pathophysiology and implementation of advanced myelographic techniques. Here, we synthesize recent updates and contextualize them in an algorithm for diagnosis and treatment of SIH, highlighting basic principles and points of practice variability or continued debate. This discussion includes finer points of SIH diagnosis, CSF leak classification systems, less common types and variants of CSF leaks, brain MRI Bern scoring, potential SIH complications, key technical considerations, and positioning strategies for different types of dynamic myelography. The roles of conservative measures, non-targeted or targeted blood patches, surgery, and recently developed endovascular techniques are presented.

Indexed as

Endovascular ProceduresIntracranial HypotensionCerebrospinal Fluid LeakHumansMagnetic Resonance ImagingMyelographyCSF leakDigital subtraction myelographyDynamic CT myelographyOrthostatic headacheSponaneous intracranial hypotensionTranvenous Onyx embolization

Identifiers

PMID36336758

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.