Conflict of Interest: None
Cerebral Venous Thrombosis in Spontaneous Intracranial Hypotension
Article first published online: 8 OCT 2008
© 2008 the Authors. Journal compilation © 2008 American Headache Society
Headache: The Journal of Head and Face Pain
Volume 48, Issue 10, pages 1511–1519, November/December 2008
How to Cite
Schievink, W. I. and Maya, M. M. (2008), Cerebral Venous Thrombosis in Spontaneous Intracranial Hypotension. Headache: The Journal of Head and Face Pain, 48: 1511–1519. doi: 10.1111/j.1526-4610.2008.01251.x
- Issue published online: 19 NOV 2008
- Article first published online: 8 OCT 2008
- Accepted for publication July 20, 2008.
- cerebral venous thrombosis;
- intracranial hypotension;
- CSF leak
Background and Objective.— The occurrence of cerebral venous thrombosis has been reported among patients with spontaneous intracranial hypotension, but a causal relationship has not been clearly established. We reviewed our experience with spontaneous intracranial hypotension and cerebral venous thrombosis and we reviewed the relevant literature to evaluate the relationship between these 2 entities.
Methods.— We reviewed the medical records and imaging studies of a consecutive group of patients with spontaneous intracranial hypotension evaluated at a tertiary care center between 1/1/2001 and 12/31/2007. The main search strategy was a systemic review of journal articles in MEDLINE (1966 to January 2008).
Results.— Among 141 patients with spontaneous intracranial hypotension, 3 (2.1%) were also diagnosed with cerebral venous thrombosis. Among these 3 patients and the 17 reported in the literature there were 11 men and 9 women with a mean age of 39.5 years. Radiographic or clinical evidence for spontaneous intracranial hypotension preceding cerebral venous thrombosis was found in most patients, while there was no evidence for cerebral venous thrombosis preceding spontaneous intracranial hypotension in any patient. Eight (40%) of the 20 patients were found to have a change in their headache pattern believed to be due to the development of cerebral venous thrombosis. Complications of cerebral venous thrombosis, eg, cerebral venous infarction, occurred in 8 patients (40%).
Conclusions.— Spontaneous intracranial hypotension is a risk factor for cerebral venous thrombosis, but cerebral venous thrombosis is found in only about 2% of patients with spontaneous intracranial hypotension. A change in headache pattern is not a reliable predictor of the development of cerebral venous thrombosis in patients with spontaneous intracranial hypotension.