2023 Cedars-Sinai Intracranial Hypotension Conference

2023 Intracranial Hypotension conference

Hosted by Cedars-Sinai 
Date: July 8-9, 2023
Location: Kohala Coast, Hawaii; and virtual
Course Co-directors: Wouter Schievink, MD & Connie Deline, MD

Read our recap of the 2023 conference here

This hybrid conference brought together clinicians and researchers to share the latest advances in the diagnostic evaluation and treatment of this under-diagnosed, disabling but treatable disorder. Invited speakers included representatives from a range of subspecialties, including anesthesiology, neurology, neurosurgery, neuroradiology, and genetics.

The topics included clinical presentations, differential diagnoses, complications, cranial and spinal imaging, percutaneous interventions, and surgical approaches. In addition, there were presentations on the anatomy of spontaneous leak types, tailored imaging and treatment approaches, iatrogenic leaks, and related disorders, along with interactive discussions about diagnostic and treatment challenges.

The event concluded with an update on recent research papers, and a discussion about opportunities for collaborative research with the Spinal CSF Leak Foundation’s new research network.

Each of the following images from the the 2023 Intracranial Hypotension Conference links out to a separate page with the talk video and associated transcript.. Most talks also have accompanying slides uploaded to our website as well. We hope that these video replays help further our mission of education, advocacy, and raising awareness for all people suffering from intracranial hypotension or spinal CSF leak.

SIH Diagnostic Basics & Challenges

Dr. Friedman video 2023 Intracranial Hypotension Conference
Clinical mimics: Post-Traumatic Headache, NDPH, and Occipital Neuralgia
Dr. Deborah Friedman, Neuro-Ophthalmologist and Headache Medicine Specialist
Dr. Wouter Schievink, 2023 Intracranial Hypotension Conference
Clinical Mimics: Behavioral Variant Frontotemporal Dementia and Bibrachial Amytrophy
Dr. Wouter Schievink, Professor of Neurosurgery, Cedars-Sinai, Los Angeles, CA.
Dr. Cindy Xi
Headache in Mast Cell Activation Syndrome: Differential Diagnosis or Comorbidity
Dr. Cindy Xi, Clinical Assistant Professor of Medicine and Section Head of Allergy & Immunology, Keck Hospital of USC, Los Angeles, CA.
SIH Cranial Imaging: Qualitative and Quantitative
Dr. Geoffrey Parker, Macquarie University Hospital, Australia.
Dr. Wouter Schievink
Types of Spontaneous Leaks: Anatomy and Pathogenesis
Dr. Wouter Schievink, Professor of Neurosurgery, Cedars-Sinai, Los Angeles, CA.
Spinal Imaging: Diagnostic Algorithm I
Dr. Marcel Maya, Professor and Co-Chair, Department of Imaging, Cedars-Sinai, Los Angeles, CA.
Dr. Peter Kranz
Spinal Imaging: Diagnostic Algorithm II, CT-Based
Dr. Peter Kranz, Associate Professor, Department of Radiology, Duke University Medical Center, Durham, NC
Beck
New diagnostics: cine MRI and CSF-PET
Dr. Jürgen Beck, Director, Department of Neurosurgery, University of Freiburg, Germany.

SIH Pathophysiology

Heritable Disorders of Connective Tissue and Spontaneous CSF Leaks
Cassie Parks, MD/PhD student at the genetic lab of Hal Dietz at The Johns Hopkins University School of Medicine.
Dr. Aruna Rao
CSF dynamics
Dr. Aruna Rao, Assistant Professor of Neurology, The Johns Hopkins University School of Medicine.

Iatrogenic leaks

Iatrogenic leaks: PDPH, needle type data; can we reduce the incidence?
Dr. Ian Carroll, Associate Professor of Anesthesiology, Perioperative, and Pain medicine; Chief, Stanford Headache Program; Stanford University.
Iatrogenic Leaks: Imaging of Post Dural Puncture Headache
Dr. Andrew Callen, Assistant Professor of Neuroradiology, Director of the CSF leak program at the University of Colorado Anschutz, Denver, Colorado.
Dr. Jürgen Beck
Iatrogenic leaks: surgical, how common and how often are they missed?
Dr. Jürgen Beck, Director, Department of Neurosurgery, University of Freiburg, Germany.

SIH Complications

Subdural hematomas in SIH: incidence, management
Dr. Jürgen Beck, Director, Department of Neurosurgery, University of Freiburg, Germany.
Cerebral venous thrombosis: incidence, management
Dr. Shuu-Jiun Wang, Professor and Director, Brain Research Center, National Yang-Ming University School; and Director of The Neurological Institute, Taipei Veterans General Hospital.
Dr. Marcus Stoodley
Spinal manifestations in SIH
Dr. Marcus Stoodley, Professor and Head of Neurosurgery at Macquarie University Hospital in Australia.
Dr. Jennifer Harris
Superficial siderosis
Dr. Jennifer Harris, assistant professor of neurology and director of vascular neurology fellowship at Cedars-Sinai.

Current and Evolving Treatment Approaches

Dr. Michael Malinzak
Percutaneous approaches to spinal CSF leaks
Dr. Mike Malinzak, assistant professor of radiology at Duke University Medical Center.
Endovascular approaches
Dr. Marcel Maya, Professor & Co-Chair, Department of Imaging, Cedars-Sinai.
Surgical approach for cervical ventral leaks
Dr. Ray Chu, Associate Professor of Neurosurgery, Cedars-Sinai.
Surgical approach for thoracic and lumbar ventral leaks
Dr. Wouter Schievink, Professor of Neurosurgery at Cedars-Sinai in Los Angeles, CA.
Surgical approaches for sacral Tarlov cysts
Dr. Rudolph Schrot, neurosurgeon at Sutter Medical Center in Sacramento, CA.

Related CSF Disorders: What Can We Learn?

Diagnostic imaging in Idiopathic Intracranial Hypertension
Dr. Mike Malinzak, assistant professor of radiology at Duke University Medical Center.
Dr. Geoffrey Parker
Endovascular approaches for Idiopathic Intracranial Hypertension
Dr. Geoffrey Parker, Macquarie University Hospital, Australia.
Shunting for Idiopathic Intracranial Hypertension
Dr. Ray Chu, Associate Professor of Neurosurgery, Cedars-Sinai.
Dr. Marcus Stoodley
Syringomyelia pathophysiology, imaging, management
Dr. Marcus Stoodley, Professor and Head of Neurosurgery at Macquarie University Hospital in Australia.

Rebound Intracranial Hypotension

Dr. Peter Kranz
RIH – diagnosis, imaging, and natural history
Dr. Peter Kranz, Associate Professor, Department of Radiology, Duke University Medical Center, Durham, NC
Dr. Deborah Friedman
RIH – medical treatment
Dr. Deborah Friedman, Neuro-Ophthalmologist and Headache Medicine Specialist.
Dr. Geoffrey Parker
RIH – interventional treatments and cautions
Dr. Geoffrey Parker, Macquarie University Hospital, Australia.

Research Updates

Quality of Life in Patients with Confirmed or Suspected Spinal CSF Leaks
​Dr. Deborah Friedman, Neuro-Ophthalmologist and Headache Medicine Specialist.
Dr. Ian Carroll
Long-term Outcomes of EBP in Patients who Fail to Meet ICHD-3 Diagnostic Criteria
​Dr. Ian Carroll, Associate Professor of Anesthesiology, Perioperative, and Pain medicine; Chief, Stanford Headache Program; Stanford University.
Beck
Quality of Life After Surgical Treatment for SIH
Dr. Jürgen Beck, Director, Department of Neurosurgery, University of Freiburg, Germany.