Today is the start of #leakweek2022!
All throughout the week, in partnership with Spinal CSF Leak Canada and the CSF Leak Association, we’ll be sharing FACTS and FICTIONS about spinal CSF leak. Test your knowledge, and share with family and friends who may not be aware!
First up:
FACT OR FICTION?
There are highly significant differences on brain MRI between patients w spinal CSF leak and patients w Chiari 1 malformation.
FACT!
According to a recent Foundation-funded study, measures of midbrain sagging discriminate Chiari 1 malformation from SIH and may help to prevent misdiagnosis and unnecessary surgery.
This retrospective study compared neuroimaging in adults with Chiari 1 and those with intracranial hypotension due to spinal CSF leak. The results showed highly significant differences between the groups.
The study’s authors (Jessica L. Houk MD, Timothy J. Amrhein MD, Linda Gray MD, Michael D. Malinzak MD, PhD, and Peter G. Kranz MD) found that measures of midbrain sagging can help differentiate between the two conditions.
Importantly, the study also showed that none of the patients with spinal CSF leak had cerebellar tonsillar ectopia WITHOUT ALSO HAVING other findings of midbrain sagging. Ultimately, the study demonstrated the importance of looking at objective measures of midbrain sagging to help prevent misdiagnosis and unnecessary surgery.