Serious risks associated with epidural steroid injections, even when rare, must be weighed against the limited potential for benefit.
Epidural Steroid Injections: Risk vs Benefit
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Updates from the Spinal CSF Leak Foundation
Positional headache not always a spinal CSF leak
What is a positional headache? The headache associated with intracranial hypotension (low fluid pressure inside the head) secondary to a spinal cerebrospinal fluid (CSF) leak is usually positional—that is, it is head pain that is worse when upright but improved when...
Imaging findings in spinal CSF leaks can be misleading
The initial treatment of spontaneous spinal cerebrospinal fluid (CSF) leaks does not require localization of the CSF leak with spinal imaging, since one or more non-directed epidural blood patches are often effective. In those situations where conservative measures or...
Investigating Brain Fog in Spontaneous Intracranial Hypotension
Numerous authors have reported on impaired cognition in patients with spontaneous intracranial hypotension secondary to spinal CSF leaks. The effects on cognition can range from subtle to severe. There are reported cases of severe impairment mimicking dementia. These...
New Case Report: SMAD3-related Aneurysms-Osteoarthritis syndrome
A new case report describes the case of a 55 year old man who presented to the emergency room with a positional headache. He was diagnosed with Spontaneous Intracranial Hypotension (SIH) with bilateral subdural fluid collections. Spinal imaging failed to reveal the...
Focus on Heritable Disorders of Connective Tissue
In cases of spontaneous spinal cerebrospinal (CSF) leaks, an underlying weakness of the dura is usually suspected. Heritable disorders of connective tissue (HDCT) cause generalized weakness of connective tissues, including but not limited to the spinal dura. Thinner,...
Day 7 of Brain Awareness Week
NEUROENDOCRINE COMPLICATIONS from low cerebrospinal fluid (CSF) volume and pressure (intracranial hypotension) from spinal CSF leaks have been seen but have not been well studied to date. The brain (hypothalamus and pituitary) is where most hormone function is...
Day 6 of Brain Awareness Week
CENTRAL NERVOUS SYSTEM effects from low CSF volume and pressure secondary to spinal CSF leaks are seen. Some symptoms may or may not be directly related to the low CSF volume and pressure but are very frequently reported: - cognitive dysfunction (concentration,...
Day 5 of Brain Awareness Week
SPINAL MANIFESTATIONS of spinal CSF (cerebrospinal) leaks occur with variable frequency. Common: - pain or tightness between shoulder blades - arm pain or numbness (from traction on cervical nerve roots) Less common: - local back pain at level of CSF leak - pain,...
Day 4 of Brain Awareness Week
Intracranial hypotension (low cerebrospinal fluid volume and pressure) from a spinal CSF leak is increasingly recognized as a cause of SUBDURAL FLUID OR BLOOD COLLECTIONS. The subdural space is just under the dural layer of the meninges, the connective tissue that...
Day 3 of Brain Awareness Week
Symptoms related to CRANIAL NERVE DYSFUNCTION occur. There are 12 pairs of cranial nerves that can be affected by the descent of the brain caused by spinal cerebrospinal fluid (CSF) leaks. Some cranial nerves are affected more commonly than others. Here we list some...
Day 2 of Brain Awareness Week
Beyond the headache that we discussed yesterday, additional symptoms occur very frequently in patients with spinal CSF (cerebrospinal fluid) leaking that are associated with IRRITATION OF THE MENINGES (connective tissue layers that hold CSF around the brain and spinal...