Brain Spontaneous Intracranial Hypotension Score for Treatment Monitoring After Surgical Closure of the Underlying Spinal Dural Leak
Background Spontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response are scarce. Purpose To assess the suitability of the brain MRI-based SIH score (bSIH) for monitoring treatment success in SIH patients with a...
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| Vydáno v: | Clinical neuroradiology (Munich) Ročník 32; číslo 1; s. 231 - 238 |
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| Hlavní autoři: | , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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Berlin/Heidelberg
Springer Berlin Heidelberg
01.03.2022
Springer Springer Nature B.V |
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| ISSN: | 1869-1439, 1869-1447, 1869-1447 |
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| Abstract | Background
Spontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response are scarce.
Purpose
To assess the suitability of the brain MRI-based SIH score (bSIH) for monitoring treatment success in SIH patients with a proven spinal cerebrospinal fluid (CSF) leak after microsurgical closure of the underlying dural breach.
Methods
This retrospective cohort study included consecutive SIH patients with a proven spinal CSF leak, investigated at dedicated referral centre January 2012 to March 2020. The bSIH score integrates 6 imaging findings; 3 major (2 points) and 3 minor (1 point), and ranges from 0 to 9, with 0 indicating low and 9 high probability of spinal CSF loss. The score was calculated using brain magnetic resonance imaging (MRI) before and after surgical treatment of the underlying CSF leak. Headache intensity was registered on a numeric rating scale (NRS) (range 0–10).
Results
In this study 52 SIH patients, 35 (67%) female, mean age 45.3 years, with a proven spinal CSF leak were included. The mean bSIH score decreased significantly from baseline to after surgical closure of the underlying dural breach (6.9 vs. 1.3,
P
< 0.001). A decrease in the NRS score was reported (8.6 vs. 1.2,
P
< 0.001).
Conclusion
The bSIH score is a simple tool which may serve to monitor treatment success in SIH patients after surgical closure of the underlying spinal dural leak. Its decrease after surgical closure of the underlying spinal dural breach indicates restoration of an equilibrium within the CSF compartment. |
|---|---|
| AbstractList | BackgroundSpontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response are scarce.PurposeTo assess the suitability of the brain MRI-based SIH score (bSIH) for monitoring treatment success in SIH patients with a proven spinal cerebrospinal fluid (CSF) leak after microsurgical closure of the underlying dural breach.MethodsThis retrospective cohort study included consecutive SIH patients with a proven spinal CSF leak, investigated at dedicated referral centre January 2012 to March 2020. The bSIH score integrates 6 imaging findings; 3 major (2 points) and 3 minor (1 point), and ranges from 0 to 9, with 0 indicating low and 9 high probability of spinal CSF loss. The score was calculated using brain magnetic resonance imaging (MRI) before and after surgical treatment of the underlying CSF leak. Headache intensity was registered on a numeric rating scale (NRS) (range 0–10).ResultsIn this study 52 SIH patients, 35 (67%) female, mean age 45.3 years, with a proven spinal CSF leak were included. The mean bSIH score decreased significantly from baseline to after surgical closure of the underlying dural breach (6.9 vs. 1.3, P < 0.001). A decrease in the NRS score was reported (8.6 vs. 1.2, P < 0.001).ConclusionThe bSIH score is a simple tool which may serve to monitor treatment success in SIH patients after surgical closure of the underlying spinal dural leak. Its decrease after surgical closure of the underlying spinal dural breach indicates restoration of an equilibrium within the CSF compartment. Spontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response are scarce. To assess the suitability of the brain MRI-based SIH score (bSIH) for monitoring treatment success in SIH patients with a proven spinal cerebrospinal fluid (CSF) leak after microsurgical closure of the underlying dural breach. This retrospective cohort study included consecutive SIH patients with a proven spinal CSF leak, investigated at dedicated referral centre January 2012 to March 2020. The bSIH score integrates 6 imaging findings; 3 major (2 points) and 3 minor (1 point), and ranges from 0 to 9, with 0 indicating low and 9 high probability of spinal CSF loss. The score was calculated using brain magnetic resonance imaging (MRI) before and after surgical treatment of the underlying CSF leak. Headache intensity was registered on a numeric rating scale (NRS) (range 0-10). In this study 52 SIH patients, 35 (67%) female, mean age 45.3 years, with a proven spinal CSF leak were included. The mean bSIH score decreased significantly from baseline to after surgical closure of the underlying dural breach (6.9 vs. 1.3, P < 0.001). A decrease in the NRS score was reported (8.6 vs. 1.2, P < 0.001). The bSIH score is a simple tool which may serve to monitor treatment success in SIH patients after surgical closure of the underlying spinal dural leak. Its decrease after surgical closure of the underlying spinal dural breach indicates restoration of an equilibrium within the CSF compartment. Background Spontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response are scarce. Purpose To assess the suitability of the brain MRI-based SIH score (bSIH) for monitoring treatment success in SIH patients with a proven spinal cerebrospinal fluid (CSF) leak after microsurgical closure of the underlying dural breach. Methods This retrospective cohort study included consecutive SIH patients with a proven spinal CSF leak, investigated at dedicated referral centre January 2012 to March 2020. The bSIH score integrates 6 imaging findings; 3 major (2 points) and 3 minor (1 point), and ranges from 0 to 9, with 0 indicating low and 9 high probability of spinal CSF loss. The score was calculated using brain magnetic resonance imaging (MRI) before and after surgical treatment of the underlying CSF leak. Headache intensity was registered on a numeric rating scale (NRS) (range 0-10). Results In this study 52 SIH patients, 35 (67%) female, mean age 45.3 years, with a proven spinal CSF leak were included. The mean bSIH score decreased significantly from baseline to after surgical closure of the underlying dural breach (6.9 vs. 1.3, Pâ¯< 0.001). A decrease in the NRS score was reported (8.6 vs. 1.2, Pâ¯< 0.001). Conclusion The bSIH score is a simple tool which may serve to monitor treatment success in SIH patients after surgical closure of the underlying spinal dural leak. Its decrease after surgical closure of the underlying spinal dural breach indicates restoration of an equilibrium within the CSF compartment. Background Spontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response are scarce. Purpose To assess the suitability of the brain MRI-based SIH score (bSIH) for monitoring treatment success in SIH patients with a proven spinal cerebrospinal fluid (CSF) leak after microsurgical closure of the underlying dural breach. Methods This retrospective cohort study included consecutive SIH patients with a proven spinal CSF leak, investigated at dedicated referral centre January 2012 to March 2020. The bSIH score integrates 6 imaging findings; 3 major (2 points) and 3 minor (1 point), and ranges from 0 to 9, with 0 indicating low and 9 high probability of spinal CSF loss. The score was calculated using brain magnetic resonance imaging (MRI) before and after surgical treatment of the underlying CSF leak. Headache intensity was registered on a numeric rating scale (NRS) (range 0–10). Results In this study 52 SIH patients, 35 (67%) female, mean age 45.3 years, with a proven spinal CSF leak were included. The mean bSIH score decreased significantly from baseline to after surgical closure of the underlying dural breach (6.9 vs. 1.3, P < 0.001). A decrease in the NRS score was reported (8.6 vs. 1.2, P < 0.001). Conclusion The bSIH score is a simple tool which may serve to monitor treatment success in SIH patients after surgical closure of the underlying spinal dural leak. Its decrease after surgical closure of the underlying spinal dural breach indicates restoration of an equilibrium within the CSF compartment. Spontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response are scarce. To assess the suitability of the brain MRI-based SIH score (bSIH) for monitoring treatment success in SIH patients with a proven spinal cerebrospinal fluid (CSF) leak after microsurgical closure of the underlying dural breach. This retrospective cohort study included consecutive SIH patients with a proven spinal CSF leak, investigated at dedicated referral centre January 2012 to March 2020. The bSIH score integrates 6 imaging findings; 3 major (2 points) and 3 minor (1 point), and ranges from 0 to 9, with 0 indicating low and 9 high probability of spinal CSF loss. The score was calculated using brain magnetic resonance imaging (MRI) before and after surgical treatment of the underlying CSF leak. Headache intensity was registered on a numeric rating scale (NRS) (range 0-10). In this study 52 SIH patients, 35 (67%) female, mean age 45.3 years, with a proven spinal CSF leak were included. The mean bSIH score decreased significantly from baseline to after surgical closure of the underlying dural breach (6.9 vs. 1.3, Pâ¯< 0.001). A decrease in the NRS score was reported (8.6 vs. 1.2, Pâ¯< 0.001). The bSIH score is a simple tool which may serve to monitor treatment success in SIH patients after surgical closure of the underlying spinal dural leak. Its decrease after surgical closure of the underlying spinal dural breach indicates restoration of an equilibrium within the CSF compartment. Spontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response are scarce.BACKGROUNDSpontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response are scarce.To assess the suitability of the brain MRI-based SIH score (bSIH) for monitoring treatment success in SIH patients with a proven spinal cerebrospinal fluid (CSF) leak after microsurgical closure of the underlying dural breach.PURPOSETo assess the suitability of the brain MRI-based SIH score (bSIH) for monitoring treatment success in SIH patients with a proven spinal cerebrospinal fluid (CSF) leak after microsurgical closure of the underlying dural breach.This retrospective cohort study included consecutive SIH patients with a proven spinal CSF leak, investigated at dedicated referral centre January 2012 to March 2020. The bSIH score integrates 6 imaging findings; 3 major (2 points) and 3 minor (1 point), and ranges from 0 to 9, with 0 indicating low and 9 high probability of spinal CSF loss. The score was calculated using brain magnetic resonance imaging (MRI) before and after surgical treatment of the underlying CSF leak. Headache intensity was registered on a numeric rating scale (NRS) (range 0-10).METHODSThis retrospective cohort study included consecutive SIH patients with a proven spinal CSF leak, investigated at dedicated referral centre January 2012 to March 2020. The bSIH score integrates 6 imaging findings; 3 major (2 points) and 3 minor (1 point), and ranges from 0 to 9, with 0 indicating low and 9 high probability of spinal CSF loss. The score was calculated using brain magnetic resonance imaging (MRI) before and after surgical treatment of the underlying CSF leak. Headache intensity was registered on a numeric rating scale (NRS) (range 0-10).In this study 52 SIH patients, 35 (67%) female, mean age 45.3 years, with a proven spinal CSF leak were included. The mean bSIH score decreased significantly from baseline to after surgical closure of the underlying dural breach (6.9 vs. 1.3, P < 0.001). A decrease in the NRS score was reported (8.6 vs. 1.2, P < 0.001).RESULTSIn this study 52 SIH patients, 35 (67%) female, mean age 45.3 years, with a proven spinal CSF leak were included. The mean bSIH score decreased significantly from baseline to after surgical closure of the underlying dural breach (6.9 vs. 1.3, P < 0.001). A decrease in the NRS score was reported (8.6 vs. 1.2, P < 0.001).The bSIH score is a simple tool which may serve to monitor treatment success in SIH patients after surgical closure of the underlying spinal dural leak. Its decrease after surgical closure of the underlying spinal dural breach indicates restoration of an equilibrium within the CSF compartment.CONCLUSIONThe bSIH score is a simple tool which may serve to monitor treatment success in SIH patients after surgical closure of the underlying spinal dural leak. Its decrease after surgical closure of the underlying spinal dural breach indicates restoration of an equilibrium within the CSF compartment. |
| Audience | Academic |
| Author | Ulrich, Christian Dobrocky, Tomas Branca, Mattia Gralla, Jan Beck, Jürgen Pilgram-Pastor, Sara Kaesmacher, Johannes Rohner, Roman Piechowiak, Eike I. Raabe, Andreas Häni, Levin Mordasini, Pasquale Cianfoni, Alessandro Schär, Ralph T. |
| Author_xml | – sequence: 1 givenname: Tomas orcidid: 0000-0002-6167-3343 surname: Dobrocky fullname: Dobrocky, Tomas email: tomas.dobrocky@insel.ch organization: Department of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital Bern, Department of Neurosurgery, Medical Center—University of Freiburg – sequence: 2 givenname: Levin surname: Häni fullname: Häni, Levin organization: Department of Neurosurgery, Inselspital, Bern University Hospital, and University of Bern – sequence: 3 givenname: Roman surname: Rohner fullname: Rohner, Roman organization: Department of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital Bern – sequence: 4 givenname: Mattia surname: Branca fullname: Branca, Mattia organization: Clinical Trial Unit, University of Bern – sequence: 5 givenname: Pasquale surname: Mordasini fullname: Mordasini, Pasquale organization: Department of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital Bern – sequence: 6 givenname: Sara surname: Pilgram-Pastor fullname: Pilgram-Pastor, Sara organization: Department of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital Bern – sequence: 7 givenname: Johannes surname: Kaesmacher fullname: Kaesmacher, Johannes organization: Department of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital Bern – sequence: 8 givenname: Alessandro surname: Cianfoni fullname: Cianfoni, Alessandro organization: Department of Neuroradiology, Neurocenter of Italian Switzerland – sequence: 9 givenname: Ralph T. surname: Schär fullname: Schär, Ralph T. organization: Department of Neurosurgery, Inselspital, Bern University Hospital, and University of Bern – sequence: 10 givenname: Jan surname: Gralla fullname: Gralla, Jan organization: Department of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital Bern – sequence: 11 givenname: Andreas surname: Raabe fullname: Raabe, Andreas organization: Department of Neurosurgery, Inselspital, Bern University Hospital, and University of Bern – sequence: 12 givenname: Christian surname: Ulrich fullname: Ulrich, Christian organization: Department of Neurosurgery, Inselspital, Bern University Hospital, and University of Bern – sequence: 13 givenname: Jürgen surname: Beck fullname: Beck, Jürgen organization: Department of Neurosurgery, Inselspital, Bern University Hospital, and University of Bern, Department of Neurosurgery, Medical Center—University of Freiburg – sequence: 14 givenname: Eike I. surname: Piechowiak fullname: Piechowiak, Eike I. organization: Department of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital Bern |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35028683$$D View this record in MEDLINE/PubMed |
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| Copyright | The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2021 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany. COPYRIGHT 2022 Springer The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2021. |
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| Keywords | CSF loss CSF leak Spontaneous intracranial hypotension bSIH score surgical closure CSF leak |
| Language | English |
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| PublicationTitle | Clinical neuroradiology (Munich) |
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| References_xml | – volume: 29 start-page: 581 year: 2019 end-page: 594 ident: CR13 article-title: Spontaneous Intracranial hypotension: pathogenesis, diagnosis, and treatment publication-title: Neuroimaging Clin N Am doi: 10.1016/j.nic.2019.07.006 – volume: 42 start-page: 882 year: 2021 end-page: 887 ident: CR17 article-title: A novel endovascular therapy for CSF hypotension secondary to CSF-venous fistulas publication-title: AJNR Am J Neuroradiol doi: 10.3174/ajnr.A7014 – volume: 84 start-page: E345 year: 2019 end-page: E351 ident: CR10 article-title: Posterior approach and spinal Cord release for 360° repair of dural defects in spontaneous intracranial hypotension publication-title: Neurosurgery doi: 10.1093/neuros/nyy312 – volume: 32 start-page: 2011 year: 2011 ident: CR14 article-title: Enlargement of the inferior intercavernous sinus: a new sign for the diagnosis of craniospinal hypotension publication-title: Am J Neuroradiol doi: 10.3174/ajnr.A2816 – volume: 95 start-page: e247 year: 2020 end-page: e255 ident: CR6 article-title: Insights into the natural history of spontaneous intracranial hypotension from infusion testing publication-title: Neurology doi: 10.1212/WNL.0000000000009812 – volume: 24 start-page: 883 year: 2004 end-page: 887 ident: CR2 article-title: Paradoxical postural headaches in cerebrospinal fluid leaks publication-title: Cephalalgia doi: 10.1111/j.1468-2982.2004.00763.x – volume: 51 start-page: 1768 year: 1998 end-page: 1769 ident: CR1 article-title: Nonpositional headache caused by spontaneous intracranial hypotension publication-title: Neurology doi: 10.1212/WNL.51.6.1768 – volume: 141 start-page: 71 year: 2016 end-page: 76 ident: CR15 article-title: A quantitative study of intracranial hypotensive syndrome by magnetic resonance publication-title: Clin Neurol Neurosurg doi: 10.1016/j.clineuro.2015.12.014 – volume: 87 start-page: 1220 year: 2016 end-page: 1226 ident: CR9 article-title: Diskogenic microspurs as a major cause of intractable spontaneous intracranial hypotension publication-title: Neurology doi: 10.1212/WNL.0000000000003122 – volume: 38 start-page: 323 year: 2018 end-page: 331 ident: CR16 article-title: Intracranial structural alteration predicts treatment outcome in patients with spontaneous intracranial hypotension publication-title: Cephalalgia doi: 10.1177/0333102417690106 – volume: 76 start-page: 580 year: 2019 end-page: 587 ident: CR8 article-title: Assessing spinal cerebrospinal fluid leaks in spontaneous intracranial hypotension with a scoring system based on brain magnetic resonance imaging findings publication-title: JAMA Neurol doi: 10.1001/jamaneurol.2018.4921 – volume: 77 start-page: 1241 year: 2002 end-page: 1246 ident: CR11 article-title: Intracranial hypertension after treatment of spontaneous cerebrospinal fluid leaks publication-title: Mayo Clin Proc doi: 10.4065/77.11.1241 – volume: 35 start-page: 1237 year: 2014 end-page: 1241 ident: CR12 article-title: Rebound intracranial hypertension: a complication of epidural blood patching for intracranial hypotension publication-title: Am J Neuroradiol doi: 10.3174/ajnr.A3841 – volume: 48 start-page: 513 year: 2001 end-page: 517 ident: CR4 article-title: Spontaneous Intracranial hypotension mimicking aneurysmal subarachnoid hemorrhage publication-title: Neurosurgery doi: 10.1097/00006123-200103000-00009 – volume: 36 start-page: 1209 year: 2016 end-page: 1217 ident: CR5 article-title: How common is normal cerebrospinal fluid pressure in spontaneous intracranial hypotension? 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Spontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response... Spontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response are scarce.... Background Spontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response... Spontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response are scarce.... BackgroundSpontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response... Spontaneous intracranial hypotension (SIH) is a debilitating condition requiring effective treatment; however, objective data on treatment response are... |
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| SubjectTerms | Back surgery Brain Cerebrospinal Fluid Leak - diagnostic imaging Cerebrospinal Fluid Leak - etiology Cerebrospinal Fluid Leak - surgery Diagnostic tests Epidural Female Fistula Headaches Humans Hypotension Intracranial Hypotension - diagnostic imaging Intracranial Hypotension - etiology Intracranial Hypotension - surgery Magnetic resonance imaging Magnetic Resonance Imaging - methods Medical imaging Medical research Medicine Medicine & Public Health Medicine, Experimental Middle Aged Neurology Neuroradiology Neurosurgery Original Article Retrospective Studies Sinuses Spine Surgery Tomography |
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| Title | Brain Spontaneous Intracranial Hypotension Score for Treatment Monitoring After Surgical Closure of the Underlying Spinal Dural Leak |
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