What is Spontaneous Intracranial Hypotension?

Category: Spine | Author: Stefano Sinicropi

Spontaneous Intracranial Hypotension

Spontaneous Intracranial Hypotension (SIH) is a condition categorized by low spinal fluid pressure in the back and brain. Oftentimes the condition is due to a spinal fluid leak, but the condition can be brought on by other issues. We discuss those issues, as well as the symptoms and treatment options of Spontaneous Intracranial Hypotension in this blog.

Symptoms of Spontaneous Intracranial Hypotension

The main symptom of low spinal fluid pressure is a headache. Oftentimes these headaches worsen when upright or while laughing, coughing and sneezing, and they get better when a person lies down. Headache pain can be throbbing or non-throbbing, and it can occur on all sides of your head.

Aside from headaches, some common symptoms associated with Spontaneous Intracranial Hypotension include:

  • Double vision
  • Sensitivity to light
  • Neck/Spinal pain
  • Nausea
  • Vomiting
  • Numbness
  • Hearing problems or changes
  • Taste changes

Causes and Treatment

Certain individuals are at an increased risk for developing Spontaneous Intracranial Hypotension. Statistics show that SIH occurs twice as frequently in women compared to men, and the average onset is at 40 years of age. People with connective tissue disorders or Chiari malformation are at a heightened risk for SIH.

In general, Spontaneous Intracranial Hypotension is caused by a spinal fluid leak caused by a minor trauma, like a hard hit to the spine during athletic activity or during a car accident. The condition can also set in if your spinal dura is in a weakened state and can’t hold spinal fluid at appropriate levels. In rare instances the condition can be brought on by dehydration or a diabetic coma.

Although the condition sounds serious, oftentimes is can be successfully managed and treated with non-operative methods. The condition can resolve its own with bed rest, increased fluid intake, intraveneous or oral caffeine/theophylline, increased salt intake and steroid therapy. Should those non-operative methods fail, your spine specialist may recommend a more hands-on approach. This will include identifying the fluid leak site with a spinal MRI and/or a spinal tap, and deciding the best course of action from there. Your doctor will likely discuss two potential options:

  • Injection – An injection of treated blood or fibrin sealant at the site of the leak can help stop the leak. If the leak site cannot be found, an epidural blood patch may be effective in stopping the leak.
  • Surgery – If injection therapy and other treatments fail, surgery to manually address the leak site may be your best option.

For more information about Spontaneous Intracranial Hypotension, or if you believe you’re suffering some of the above symptoms, contact a spine specialist in your area.

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