Evidence map›Paper›PMID 41838155›Full record

Observational studyEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Audiovestibular manifestations of intracranial hypotension: a descriptive clinical series.

Douglas Henderson, Bianca Pirlog, Charlotte Hautefort, Philippe Herman, Michael Eliezer, Caroline Roos, Cassandre Djian

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Douglas HendersonCentre de Référence des Maladies Vestibulaires et Cochléo-vestibulaires Rares (VERTICO), Institut Pasteur, AP-HP, Hôpital Lariboisière, Fondation Pour l'Audition, IHU reConnect, Université Paris cité, 75010, Paris, France. douglas.henderson@aphp.fr.ORCID http://orcid.org/0009-0008-1610-5081
Bianca PirlogDepartment of Neurology, Emergency Headache Center, Lariboisière Hospital, AP-HP, Paris, France.
Charlotte HautefortCentre de Référence des Maladies Vestibulaires et Cochléo-vestibulaires Rares (VERTICO), Institut Pasteur, AP-HP, Hôpital Lariboisière, Fondation Pour l'Audition, IHU reConnect, Université Paris cité, 75010, Paris, France.
Philippe HermanDepartment of ENT and Head and Neck Surgery, Lariboisière Hospital, AP- HP, Paris, France.
Michael EliezerDepartment of Radiology, Hôpital des 15-20, Paris, 75571, France.
Caroline RoosDepartment of Neurology, Emergency Headache Center, Lariboisière Hospital, AP-HP, Paris, France.
Cassandre DjianCentre de Référence des Maladies Vestibulaires et Cochléo-vestibulaires Rares (VERTICO), Institut Pasteur, AP-HP, Hôpital Lariboisière, Fondation Pour l'Audition, IHU reConnect, Université Paris cité, 75010, Paris, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntracranial hypotension (IH) results from decreased cerebrospinal fluid (CSF) volume or pressure and typically presents with orthostatic headache. IH may also manifest with audiovestibular symptoms with variable association to endolymphatic hydrops (EH). However, the nature of this relationship remains unclear.

objectivesTo describe the clinical, audiometric, vestibular, and imaging characteristics of patients with IH presenting with cochleovestibular dysfunction.

methodsWe conducted a retrospective observational study including 12 patients diagnosed with IH based on MRI findings between 2016 and 2025 in a tertiary referral center. Data included demographic, audiovestibular, neurological, and imaging results. Descriptive statistics including patients with and without EH on MRI were reported.

resultsTwelve patients (mean age 53.4 ± 19.2 years; 50% female) with MRI-confirmed non iatrogenic IH were included. Orthostatic headache was present in 83.3% of cases. Audiovestibular symptoms were common, including tinnitus (66.7%), rotational vertigo (50.0%), positional vertigo (16.67%), instability (41.7%), ear fullness (41.7%), and hearing loss (41.7%). Audiometry revealed overall mild sensorineural hearing impairment, while vestibular testing showed largely preserved video head impulse test gains and minimal caloric deficits. Delayed post-contrast 3D FLAIR MRI identified EH in four patients (33.3%), with bilateral involvement in two (16.7%); all cases were classified as low-grade saccular hydrops.

conclusionsAudiovestibular symptoms, including tinnitus and dizziness, may accompany IH. MRI evidence of EH may support the hypothesis of a potential underlying CSF–inner ear pressure interaction. Future prospective studies should explore mechanistic pathways linking CSF hypovolemia to cochleovestibular dysfunction and EH, and gather data from larger cohorts. At this stage, the therapeutic implications remain uncertain. To our knowledge, this is the first study to perform delayed 3D FLAIR MRI in a cohort of patients with IH and cochleovestibular symptoms.

Indexed as

Endolymphatic HydropsIntracranial HypotensionVestibular DiseasesAdultAgedAudiometryAuditory AcuityFemaleHeadacheHearing Loss, SensorineuralHumansMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesVertigoAudiovestibular dysfunctionCerebrospinal fluid leakHearing lossIntracranial hypotensionSpontaneous intracranial hypotensionVestibular symptoms

Identifiers

PMID41838155

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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.