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

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.

SIH Diagnostic Basics & Challenges

Clinical mimics: Post-Traumatic Headache, NDPH, and Occipital Neuralgia
Dr. Deborah Friedman, Neuro-Ophthalmologist and Headache Medicine Specialist.
Slides | Transcript

Clinical Mimics: Behavioral Variant Frontotemporal Dementia and Bibrachial Amytrophy
Dr. Wouter Schievink, Professor of Neurosurgery, Cedars-Sinai, Los Angeles, CA.
Slides | Transcript

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.
Slides | Transcript

SIH Cranial Imaging: Qualitative and Quantitative
Dr. Geoffrey Parker, Macquarie University Hospital, Australia.
Slides | Transcript

Types of Spontaneous Leaks: Anatomy and Pathogenesis
Dr. Wouter Schievink, Professor of Neurosurgery, Cedars-Sinai, Los Angeles, CA.
Slides | Transcript

Spinal Imaging: Diagnostic Algorithm I
Dr. Marcel Maya, Professor and Co-Chair, Department of Imaging, Cedars-Sinai, Los Angeles, CA.
Transcript

Spinal Imaging: Diagnostic Algorithm II, CT-Based
Dr. Peter Kranz, Associate Professor, Department of Radiology, Duke University Medical Center, Durham, NC
Slides | Transcript

New diagnostics: cine MRI and CSF-PET
Dr. Jürgen Beck, Director, Department of Neurosurgery, University of Freiburg, Germany.
Transcript

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.
Slides | Transcript

CSF dynamics
Dr. Aruna Rao, Assistant Professor of Neurology, The Johns Hopkins University School of Medicine.
Transcript

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.
Transcript

Iatrogenic leaks: surgical, how common and how often are they missed?
Dr. Jürgen Beck, Director, Department of Neurosurgery, University of Freiburg, Germany.
Transcript

SIH Complications

Subdural hematomas in SIH: incidence, management
Dr. Jürgen Beck, Director, Department of Neurosurgery, University of Freiburg, Germany.
Transcript

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.
Transcript

Spinal manifestations in SIH
Dr. Marcus Stoodley, Professor and Head of Neurosurgery at Macquarie University Hospital in Australia.
Transcript

Superficial siderosis
Dr. Jennifer Harris, assistant professor of neurology and director of vascular neurology fellowship at Cedars-Sinai.
Transcript

Current and Evolving Treatment Approaches

Percutaneous approaches to spinal CSF leaks
Dr. Mike Malinzak, assistant professor of radiology at Duke University Medical Center.
Transcript

Endovascular approaches
Dr. Marcel Maya, Professor & Co-Chair, Department of Imaging, Cedars-Sinai.
Transcript

Dr. Ray Chu

Surgical approach for cervical ventral leaks
Dr. Ray Chu, Associate Professor of Neurosurgery, Cedars-Sinai.
Transcript

Surgical approach for thoracic and lumbar ventral leaks
Dr. Wouter Schievink, Professor of Neurosurgery at Cedars-Sinai in Los Angeles, CA.
Transcript

Dr. Rudolph Schrot

Surgical approaches for sacral Tarlov cysts
Dr. Rudolph Schrot, neurosurgeon at Sutter Medical Center in Sacramento, CA.
Transcript

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.
Transcript

Endovascular approaches for Idiopathic Intracranial Hypertension
Dr. Geoffrey Parker, Macquarie University Hospital, Australia.
Transcript

Shunting for Idiopathic Intracranial Hypertension
Dr. Ray Chu, Associate Professor of Neurosurgery, Cedars-Sinai.
Transcript

Syringomyelia pathophysiology, imaging, management
Dr. Marcus Stoodley, Professor and Head of Neurosurgery at Macquarie University Hospital in Australia.
Transcript

Rebound Intracranial Hypotension

RIH – diagnosis, imaging, and natural history
Dr. Peter Kranz, Associate Professor, Department of Radiology, Duke University Medical Center, Durham, NC
Transcript

RIH – medical treatment
Dr. Deborah Friedman, Neuro-Ophthalmologist and Headache Medicine Specialist.
Transcript

RIH – interventional treatments and cautions
Dr. Geoffrey Parker, Macquarie University Hospital, Australia.
Transcript

Research Updates

Quality of Life in Patients with Confirmed or Suspected Spinal CSF Leaks
​Dr. Deborah Friedman, Neuro-Ophthalmologist and Headache Medicine Specialist.
Transcript

Quality of Life After Surgical Treatment for SIH
Dr. Jürgen Beck, Director, Department of Neurosurgery, University of Freiburg, Germany.
Transcript