Jesse, Christopher Marvin; Schär, Ralph T; Goldberg, Johannes; Fung, Christian; Ulrich, Christian Thomas; Dobrocky, Tomas; Piechowiak, Eike Immo; Schankin, Christoph J; Beck, Jürgen; Raabe, Andreas; Häni, Levin (2024). Patient-reported symptomatology and its course in spontaneous intracranial hypotension - Beware of a chameleon. Clinical neurology and neurosurgery, 236(108087), p. 108087. Elsevier 10.1016/j.clineuro.2023.108087
|
Text
1-s2.0-S0303846723005036-main.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (1MB) | Preview |
OBJECTIVE
Although orthostatic headache is the hallmark symptom of spontaneous intracranial hypotension (SIH), patients can present with a wide range of different complaints and thereby pose a diagnostic challenge for clinicians. Our aim was to describe and group the different symptoms associated with SIH and their course over time.
METHODS
We retrospectively surveyed consecutive patients diagnosed and treated for SIH at our institution from January 2013 to May 2020 with a specifically designed questionnaire to find out about their symptomatology and its course.
RESULTS
Of 112 eligible patients, 79 (70.5%) returned the questionnaire and were included in the analysis. Of those, 67 (84.8%) reported initial orthostatic headaches, whereas 12 (15.2%) denied having this initial symptom. All except one (98.7%) patients reported additional symptoms: most frequently cephalic pressure (69.6%), neck pain (68.4%), auditory disturbances (59.5%), nausea (57%), visual disturbances (40.5%), gait disturbance (20.3%), confusion (10.1%) or sensorimotor deficits (21.5%). Fifty-seven (72.2%) patients reported a development of the initial symptoms predominantly in the first three months after symptom onset. Age and sex were not associated with the symptomatology or its course (p > 0.1).
CONCLUSION
Although characteristic of SIH, a relevant amount of patients present without orthostatic headaches. In addition, SIH can manifest with non-orthostatic headaches at disease onset or during the course of the disease. Most patients report a wide range of associated complaints. A high degree of suspicion is crucial for an early diagnosis and targeted treatment.
Actions (login required)
 |
Edit item |