Evidence map›Paper›PMID 37015821›Full record

ArticleNeurology2023

Relationship of Bern Score, Spinal Elastance, and Opening Pressure in Patients With Spontaneous Intracranial Hypotension.

Andrew L Callen, Jack Pattee, Ashesh A Thaker, Vincent M Timpone, David A Zander, Ryan Turner, Marius Birlea, Danielle Wilhour, Chantal O'Brien, Jennifer Evan and 2 more

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In one paragraph

Article in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed
10.3field-weighted citation impact, top 1% of its field
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

26 citing papers in PubMed, 51 citations in OpenAlex.

  1. Article
  2. Review
  3. Efficacy of transvenous embolization of CSF-venous fistula in spontaneous intracranial hypotension: Case-series.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026
    Article
  4. Review
  5. Review
  6. Article
  7. Article
  8. Observational
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Review
  18. Rebound Intracranial Hypertension.Current pain and headache reports · 2024
    Review
  19. Article
  20. Article
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

12 authors at 1 institution in 1 country.

Andrew L CallenFrom the Neuroradiology Section (A.C., A.A.T., V.M.T., D.Z., R.T.), Department of Radiology, Headache Section (M.B., D.W., C.O.B., J.E.), Department of Neurology, and Neurosurgery (F.G.), University of Colorado Anschutz Medical Campus, Aurora; Department of Biostatistics & Informatics (J.P.), Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora and Department of Anesthesiology (I.C.), Perioperative and Pain Medicine, Stanford University, CA. andrew.callen@cuanschutz.edu.
Jack PatteeFrom the Neuroradiology Section (A.C., A.A.T., V.M.T., D.Z., R.T.), Department of Radiology, Headache Section (M.B., D.W., C.O.B., J.E.), Department of Neurology, and Neurosurgery (F.G.), University of Colorado Anschutz Medical Campus, Aurora; Department of Biostatistics & Informatics (J.P.), Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora and Department of Anesthesiology (I.C.), Perioperative and Pain Medicine, Stanford University, CA.
Ashesh A ThakerFrom the Neuroradiology Section (A.C., A.A.T., V.M.T., D.Z., R.T.), Department of Radiology, Headache Section (M.B., D.W., C.O.B., J.E.), Department of Neurology, and Neurosurgery (F.G.), University of Colorado Anschutz Medical Campus, Aurora; Department of Biostatistics & Informatics (J.P.), Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora and Department of Anesthesiology (I.C.), Perioperative and Pain Medicine, Stanford University, CA.ORCID 0000-0001-5238-0429
Vincent M TimponeFrom the Neuroradiology Section (A.C., A.A.T., V.M.T., D.Z., R.T.), Department of Radiology, Headache Section (M.B., D.W., C.O.B., J.E.), Department of Neurology, and Neurosurgery (F.G.), University of Colorado Anschutz Medical Campus, Aurora; Department of Biostatistics & Informatics (J.P.), Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora and Department of Anesthesiology (I.C.), Perioperative and Pain Medicine, Stanford University, CA.ORCID 0000-0003-3519-846X
David A ZanderFrom the Neuroradiology Section (A.C., A.A.T., V.M.T., D.Z., R.T.), Department of Radiology, Headache Section (M.B., D.W., C.O.B., J.E.), Department of Neurology, and Neurosurgery (F.G.), University of Colorado Anschutz Medical Campus, Aurora; Department of Biostatistics & Informatics (J.P.), Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora and Department of Anesthesiology (I.C.), Perioperative and Pain Medicine, Stanford University, CA.
Ryan TurnerFrom the Neuroradiology Section (A.C., A.A.T., V.M.T., D.Z., R.T.), Department of Radiology, Headache Section (M.B., D.W., C.O.B., J.E.), Department of Neurology, and Neurosurgery (F.G.), University of Colorado Anschutz Medical Campus, Aurora; Department of Biostatistics & Informatics (J.P.), Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora and Department of Anesthesiology (I.C.), Perioperative and Pain Medicine, Stanford University, CA.
Marius BirleaFrom the Neuroradiology Section (A.C., A.A.T., V.M.T., D.Z., R.T.), Department of Radiology, Headache Section (M.B., D.W., C.O.B., J.E.), Department of Neurology, and Neurosurgery (F.G.), University of Colorado Anschutz Medical Campus, Aurora; Department of Biostatistics & Informatics (J.P.), Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora and Department of Anesthesiology (I.C.), Perioperative and Pain Medicine, Stanford University, CA.
Danielle WilhourFrom the Neuroradiology Section (A.C., A.A.T., V.M.T., D.Z., R.T.), Department of Radiology, Headache Section (M.B., D.W., C.O.B., J.E.), Department of Neurology, and Neurosurgery (F.G.), University of Colorado Anschutz Medical Campus, Aurora; Department of Biostatistics & Informatics (J.P.), Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora and Department of Anesthesiology (I.C.), Perioperative and Pain Medicine, Stanford University, CA.
Chantal O'BrienFrom the Neuroradiology Section (A.C., A.A.T., V.M.T., D.Z., R.T.), Department of Radiology, Headache Section (M.B., D.W., C.O.B., J.E.), Department of Neurology, and Neurosurgery (F.G.), University of Colorado Anschutz Medical Campus, Aurora; Department of Biostatistics & Informatics (J.P.), Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora and Department of Anesthesiology (I.C.), Perioperative and Pain Medicine, Stanford University, CA.
Jennifer EvanFrom the Neuroradiology Section (A.C., A.A.T., V.M.T., D.Z., R.T.), Department of Radiology, Headache Section (M.B., D.W., C.O.B., J.E.), Department of Neurology, and Neurosurgery (F.G.), University of Colorado Anschutz Medical Campus, Aurora; Department of Biostatistics & Informatics (J.P.), Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora and Department of Anesthesiology (I.C.), Perioperative and Pain Medicine, Stanford University, CA.
Fabio GrassiaFrom the Neuroradiology Section (A.C., A.A.T., V.M.T., D.Z., R.T.), Department of Radiology, Headache Section (M.B., D.W., C.O.B., J.E.), Department of Neurology, and Neurosurgery (F.G.), University of Colorado Anschutz Medical Campus, Aurora; Department of Biostatistics & Informatics (J.P.), Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora and Department of Anesthesiology (I.C.), Perioperative and Pain Medicine, Stanford University, CA.
Ian R CarrollFrom the Neuroradiology Section (A.C., A.A.T., V.M.T., D.Z., R.T.), Department of Radiology, Headache Section (M.B., D.W., C.O.B., J.E.), Department of Neurology, and Neurosurgery (F.G.), University of Colorado Anschutz Medical Campus, Aurora; Department of Biostatistics & Informatics (J.P.), Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora and Department of Anesthesiology (I.C.), Perioperative and Pain Medicine, Stanford University, CA.
University of Colorado Anschutz Medical Campus · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesExisting tools to diagnose spontaneous intracranial hypotension (SIH), namely spinal opening pressure (OP) and brain MRI, have limited sensitivity. We investigated whether evaluation of brain MRI using the Bern score, combined with calculated craniospinal elastance, would aid in diagnosing SIH and provide insight into its pathophysiology.

methodsA retrospective chart review was performed of patients who underwent brain MRI and pressure-augmented dynamic CT myelography (dCTM) for suspicion of SIH. Two blinded neuroradiologists assigned Bern scores for each brain MRI. OP and incremental pressure changes after intrathecal saline infusion were recorded to calculate craniospinal elastance. The relationship between Bern score, OP, and elastance and whether a leak was found were analyzed.

resultsSeventy-two consecutive dCTMs were performed in 53 patients. Twelve CSF-venous fistulae, 2 ruptured meningeal diverticula, 2 dural defects, and 1 dural bleb were found (17/53, 32%). Among patients with imaging-proven CSF leak/fistula, OP was normal in all but 1 patient and was not significantly different in those with a leak compared with those without (15.1 vs 13.6 cm H DISCUSSION: OP is not an effective predictor for diagnosing CSF leak and if used in isolation would result in misdiagnosis of 94% of patients in our cohort. The Bern score was associated with a higher diagnostic yield of dCTM. Elastance was significantly associated with certain components of the Bern score.

Indexed as

Intracranial HypotensionCerebrospinal Fluid LeakHumansMagnetic Resonance ImagingMyelographyRetrospective StudiesSpine

Identifiers

PMID37015821
PMCPMC10259284
OpenAlexW4362594526

What OpenQuestion holds

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