Commentary

Brain Awareness Week 2021: Head Pain and Spinal CSF Leak

Brain Awareness Week 2021: Head Pain and Spinal CSF Leak

Each day this week, we’ll be discussing some of the neurological symptoms and complications related to spinal cerebrospinal fluid (CSF) leak. Up first, by far the most common symptom (though not seen in every patient): Headache. The loss of CSF volume due to a leak...

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Brain Awareness Week 2021: Subdural Fluid Collections and Meningeal Involvement in Spinal CSF Leak

Let’s make misdiagnosis the exception

In recent years, the awareness of spontaneous intracranial hypotension (SIH) has increased such that more patients are being diagnosed correctly. But sadly, misdiagnosis remains the rule rather than the exception. Too many suffer for months, years, or even decades...

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Are all CSF leaks similar?

Often, when referring to any kind of cerebrospinal fluid leak, the non-specific term CSF leak is used. Few realize that a CSF leak may arise in the head OR in the spine, AND that these are two different disorders. Let’s try to clear up some of the confusion. What is a...

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Intracranial hypotension – many mimics

Intracranial hypotension – many mimics

The diagnosis of intracranial hypotension due to spinal cerebrospinal fluid (CSF) leak can be challenging for physicians and other healthcare professionals. Even though the most frequent symptom is a positional headache – worse after minutes to hours upright and...

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Pseudo-Chiari or Chiari Mimic in Intracranial Hypotension

Pseudo-Chiari or Chiari Mimic in Intracranial Hypotension

Because September is Chiari Awareness Month, we wish to draw attention to a diagnostic pitfall where intracranial hypotension (low intracranial cerebrospinal fluid volume/pressure) due to spinal cerebrospinal fluid (CSF) leak is concerned. When MRI of the brain is...

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Do Spinal CSF Leak Patients Need Additional Vaccinations?

Do Spinal CSF Leak Patients Need Additional Vaccinations?

  This is a common question. In the ACIP (Advisory Committee on Immunization Practices) recommendations, pneumococcal vaccination is recommended for patients with "CSF leaks", without distinguishing between cranial CSF leak with an anatomic barrier defect and...

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