Evidence map›Paper›PMID 40781935›Full record

Observational studyEuropean journal of neurology2025

Headache After Sealing of Cerebrospinal Fluid Leaks in Patients With Spontaneous Intracranial Hypotension.

Adrian Scutelnic, Andreas Lüthi, Isabelle Dominique Stöckli, Lucie Justus, Bettina Bracher, Antonia Klein, Nedelina Slavova, Eric Morel, Franz Riederer, Tomas Dobrocky and 6 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
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

16 authors.

Adrian ScutelnicDepartment of Neurology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.ORCID 0000-0001-9053-584X
Andreas LüthiDepartment of Neurology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
Isabelle Dominique StöckliDepartment of Neurology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
Lucie JustusDepartment of Neurology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
Bettina BracherDepartment of Neurology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
Antonia KleinDepartment of Neurology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
Nedelina SlavovaDepartment of Neurology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
Eric MorelDepartment of Neurology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
Franz RiedererDepartment of Neurology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.ORCID 0000-0002-9722-9754
Tomas DobrockyInstitute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
Eike I PiechowiakInstitute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
C Marvin JesseDepartment of Neurology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
Christian T UlrichNeurosurgery, Lindenhofspital Bern, Bern, Switzerland.
Jürgen BeckDepartment of Neurosurgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.ORCID 0000-0002-7687-6098
Ralph T SchärNeurosurgery, Lindenhofspital Bern, Bern, Switzerland.
Christoph J SchankinDepartment of Neurology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.ORCID 0000-0003-4668-6098

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSpontaneous intracranial hypotension (SIH) is an important cause of headache that might require invasive treatment. The aim of this study was to systematically investigate (1) clinical presentation, (2) factors associated with incomplete headache resolution, and (3) the long-term outcomes in patients with persistent headache after invasive treatment for SIH.

methodsThis is an observational longitudinal study. We used a structured questionnaire to assess details on primary headache, SIH-headache, and headache after treatment. Persistent headache was defined as headache on more than 15 days per month lasting longer than 3 months.

resultsFifty-six patients invasively treated for SIH were included in the study. The mean age was 49 ± 12 years, and 60% were women. After sealing of the leak, 11/56 (20%) had persistent headache. Compared to subjects without persistent headache, patients with persistent headache had been treated after a longer delay from SIH symptom onset (362 days [IQR 138-714] vs. 111 [68-365]). In 2/11 (18%) patients, a second leak at another level and rebound intracranial hypertension were found, respectively. Medication overuse was reported by 3/11 (27%) patients. After a median follow-up of 5 years, headache subsided completely in 4/11 (36%) patients and improved in 4/11 (36%).

conclusionIn our cohort, one fifth of patients suffered from persistent headache despite successful sealing of the CSF leak. Although the majority of patients showed improvement in the long run, important secondary headaches should be considered, namely medication overuse, rebound hypertension, and a persistent, reopened, de novo or second leak at another level.

Indexed as

Cerebrospinal Fluid LeakHeadacheIntracranial HypotensionAdultFemaleHumansLongitudinal StudiesMaleMiddle AgedCSF leakCSF‐venous fistulamedication overuse headachemyelographypersistent headachesecondary headacheSIHsurgical sealing of CSF leak

Identifiers

PMID40781935
PMCPMC12334888

What OpenQuestion holds

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Registered trials

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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.