ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026
Spontaneous intracranial hypotension: A stepwise diagnostic and therapeutic workflow from a tertiary referral center.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 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
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSpontaneous intracranial hypotension (SIH) is caused by spinal cerebrospinal fluid (CSF) leakage leading to intracranial CSF hypovolemia and orthostatic headache. Diagnostic and therapeutic strategies remain heterogeneous across institutions. We report the outcomes of a structured stepwise diagnostic and therapeutic pathway applied in a tertiary referral center.
methodsWe performed a retrospective analysis of 106 consecutive patients treated for SIH between 2020 and 2025. All patients were managed according to a standardized escalation protocol including conservative treatment, non-targeted epidural blood patch (nt-EBP), advanced spinal leak localization with dynamic CT myelography, and etiology-directed surgical or endovascular treatment when indicated.
resultsInitial nt-EBP resulted in complete clinical resolution in 64 patients. Forty-two patients with persistent or recurrent symptoms underwent advanced spinal imaging. Among them, 8 patients were diagnosed with lateral nerve root sleeve leaks and 4 with ventral dural tears related to osteophytes, all treated surgically, while 10 patients were diagnosed with CSF-venous fistulas and underwent transvenous embolization. All patients receiving etiology-directed surgical or endovascular treatment achieved complete clinical and radiological resolution. The remaining 20 patients without identifiable focal leak sites were managed with repeated nt-EBP, achieving partial clinical improvement and remaining under follow-up.
conclusionsA structured stepwise management strategy improves diagnostic efficiency and therapeutic outcomes in SIH. Non-targeted epidural blood patch remains an effective first-line intervention. Early escalation to targeted spinal imaging in refractory cases enables etiology-directed surgical or endovascular treatment, which can provide definitive clinical and radiological cure in selected patients.
Indexed as
Identifiers
42669760What 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.