PT  - JOURNAL ARTICLE
AU  - Ram Vaidhyanath
AU  - Richard Kenningham
AU  - Arshad Khan
AU  - Nicholas Messios
TI  - Spontaneous intracranial hypotension: a cause of severe acute headache
AID  - 10.1136/emj.2007.048694
DP  - 2007 Oct 01
TA  - Emergency Medicine Journal
PG  - 739--741
VI  - 24
IP  - 10
4099  - http://emj.bmj.com/content/24/10/739.short
4100  - http://emj.bmj.com/content/24/10/739.full
SO  - Emerg Med J2007 Oct 01; 24
AB  - Severe acute headache is a common presenting symptom to an accident and emergency department. Spontaneous intracranial hypotension (SIH) is an increasingly recognised cause of these symptoms and has characteristic clinical and imaging findings. SIH is characterised by headache worse on standing, low opening cerebrospinal fluid pressures at lumbar puncture and uniform pachymeningeal enhancement with gadolinium enhanced magnetic resonance imaging of the brain, all in the absence of dural trauma. Atypical presentations occur and severe neurological decline can rarely be associated with this condition. A review of five patients presenting recently to our institution with classical imaging findings together with a review of the literature is presented.