Observational studyNeurologia medico-chirurgica2026
Detection of Cerebrospinal Fluid-venous Fistulas Using Digital Subtraction Myelography in Refractory Spontaneous Intracranial Hypotension: A Single-center Study in an Asian Population.
Observational study in Neurologia medico-chirurgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cerebrospinal fluid-venous fistulas are increasingly recognized as a cause of spontaneous intracranial hypotension, particularly in patients who do not respond to conventional therapies. Although widely reported in Western populations, their prevalence and diagnosis in Asian cohorts remain underexplored. This study aimed to evaluate the utility of digital subtraction myelography in diagnosing cerebrospinal fluid-venous fistulas in Japanese patients with refractory spontaneous intracranial hypotension. We retrospectively analyzed adult patients with spontaneous intracranial hypotension who underwent digital subtraction myelography at our hospital between December 2024 and July 2025. The inclusion criterion was failure of 3 or more epidural blood patches. Digital subtraction myelography was performed using a standardized protocol with tilt-table positioning and contrast-enhanced imaging. The clinical and imaging data were reviewed. Ten patients (15 digital subtraction myelography studies) were included. Cerebrospinal fluid-venous fistulas were detected in 6 of 7 spinal longitudinal epidural collections-negative patients (85.7%). Spinal longitudinal epidural collections-positive patients (3/10) did not have cerebrospinal fluid-venous fistulas. Computed tomography after digital subtraction myelography demonstrated contrast accumulation in the renal pelvis in 88.9% of the cases with positive cerebrospinal fluid-venous fistula or spinal longitudinal epidural collection findings. One illustrative patient underwent Onyx embolization, resulting in marked symptom improvement. In this pilot study, cerebrospinal fluid-venous fistulas were found to be a relevant and treatable cause of refractory spontaneous intracranial hypotension in Asian patients. Digital subtraction myelography proved to be a valuable diagnostic tool, particularly in the absence of spinal longitudinal epidural collections on initial imaging.
Indexed as
Identifiers
What OpenQuestion holds
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.