GuidelineJournal of neurology, neurosurgery, and psychiatry2023
Multidisciplinary consensus guideline for the diagnosis and management of spontaneous intracranial hypotension.
Guideline in Journal of neurology, neurosurgery, and psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 3 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.
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Who cites it
68 citing papers in PubMed, 3 syntheses or guidelines pooled it, 97 citations in OpenAlex.
- Temporal and regional trends in the diagnosis and treatment of spontaneous intracranial hypotension: a systematic review.The journal of headache and pain · 2026Pooled it
- Targeted Versus NonTargeted Epidural Blood Patch for Spontaneous Intracranial Hypotension: A Systematic Review and Meta-Analysis.European journal of neurology · 2025Pooled it
- Spontaneous intracranial hypotension with negative brain MRI findings: a systematic review of diagnostic strategies and clinical outcomes.Frontiers in neurologyPooled it
- Brain distortion and cerebrospinal fluid shifts in spontaneous intracranial hypotension.Fluids and barriers of the CNS · 2026Article
- Misdiagnosis and multidisciplinary management of cerebral venous sinus thrombosis in the puerperal period: A case report and review of current literature.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Frequency and characteristics of multi-domain autonomic dysfunction in patients with spontaneous intracranial hypotension.Headache · 2026Article
- Predictive factors of epidural blood patch success in intracranial hypotension syndrome.Headache · 2026Article
- Technical Considerations Regarding Targeted Epidural Blood Patching at C1-C2 for Symptomatic Spontaneous Intracranial Hypotension.Pain practice : the official journal of World Institute of Pain · 2026Article
- 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 · 2026Article
- Pulsatile intraspinal pressure drives post-traumatic syringomyelia: evidence supporting the CSF pulsatile pressure dynamic equilibrium hypothesis.Fluids and barriers of the CNS · 2026Article
- Age-related differences in clinical manifestations, neuroimaging features, and treatment of spontaneous intracranial hypotension: a retrospective cohort study.BMC neurology · 2026Article
- Spontaneous intracranial hypotension complicated by subdural hemorrhage and life-threatening epidural hemorrhage: case report and review of the literature.Journal of neurology · 2026Article
- Ten-year spontaneous intracranial hypotension with acquired tonsillar descent and syringomyelia from a T3-4 ventral dural defect: importance of digital subtraction myelography localization and role of direct repair. Illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- CGRP-pathway exposure during the pre-EBP interval in spontaneous intracranial hypotension: an exploratory retrospective case series.BMC neurology · 2026Article
- Surgical Treatment of Spontaneous Intracranial Hypotension: Clinical Characteristics and Outcomes in a Surgically Treated Cohort of Type 1 and Type 3 Leaks.Journal of clinical medicine · 2026Article
- Modifiable and clinically actionable exposures for vascular dementia: a structured evidence synthesis of Mendelian randomization studies.Journal of neurology · 2026Review
- Non-targeted thoracic epidural blood patch for spontaneous intracranial hypotension complicated by bilateral subdural haemorrhages in a patient with end-stage renal failure: case based review.Irish journal of medical science · 2026Review
- Article
- Manual Therapy-Associated Dural Tear Causing Intracranial Hypotension Treated with an Epidural Blood Patch: A Case Report.Journal of clinical medicine · 2026Article
- "Getting to diagnosis was an absolute nightmare": survey insights about the lived experience of spinal CSF leak in Australia and Aotearoa New Zealand.Journal of neurology · 2026Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
33 authors at 14 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe aimed to create a multidisciplinary consensus clinical guideline for best practice in the diagnosis, investigation and management of spontaneous intracranial hypotension (SIH) due to cerebrospinal fluid leak based on current evidence and consensus from a multidisciplinary specialist interest group (SIG).
methodsA 29-member SIG was established, with members from neurology, neuroradiology, anaesthetics, neurosurgery and patient representatives. The scope and purpose of the guideline were agreed by the SIG by consensus. The SIG then developed guideline statements for a series of question topics using a modified Delphi process. This process was supported by a systematic literature review, surveys of patients and healthcare professionals and review by several international experts on SIH.
resultsSIH and its differential diagnoses should be considered in any patient presenting with orthostatic headache. First-line imaging should be MRI of the brain with contrast and the whole spine. First-line treatment is non-targeted epidural blood patch (EBP), which should be performed as early as possible. We provide criteria for performing myelography depending on the spine MRI result and response to EBP, and we outline principles of treatments. Recommendations for conservative management, symptomatic treatment of headache and management of complications of SIH are also provided.
conclusionsThis multidisciplinary consensus clinical guideline has the potential to increase awareness of SIH among healthcare professionals, produce greater consistency in care, improve diagnostic accuracy, promote effective investigations and treatments and reduce disability attributable to SIH.
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Registered trials
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.