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Letter
Comment on: multidisciplinary consensus guideline for the diagnosis and management of spontaneous intracranial hypotension
  1. Antonio Esposito1,2,
  2. Lorenzo Ugga3,
  3. Enrico Tedeschi3,
  4. Rosa Iodice1,2,
  5. Marcello Moccia2,4
  1. 1 Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Napoli, Italy
  2. 2 Neurology Unit, Policlinico Federico II University Hospital, Naples, Italy
  3. 3 Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
  4. 4 Department of Molecular Medicine and Medical Biotechnology, University of Naples “FedericoII”, Naples, Italy
  1. Correspondence to Dr Marcello Moccia; marcello.moccia{at}unina.it

https://doi.org/10.1136/jnnp-2023-331981

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    Dear editor,

    Over the last years, advances in spontaneous intracranial hypotension (SIH) have allowed earlier and more accurate diagnosis, when compared with the past, with better management and lower rates of complications.1 Most cases of SIH are deemed to result from spontaneous cerebrospinal fluid (CSF) leaks. CSF leakage from disrupted spinal meninges can cause epidural collections, then leading to intracranial hypotension and postural headache. Accordingly, MRI frequently shows such spinal CSF collections in association with brain abnormalities including pachymeningeal enhancement, subdural effusions and sagging brainstem.2

    In keep with this, we read with great interest the recent work from Cheema et al ‘Multidisciplinary consensus guideline for the diagnosis and management of SIH’, and specifically commend their efforts at homogenising SIH workflow.3 Their paper …

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    Footnotes

    • Twitter @Antonio_Espo12, @MarcelloMoccia_

    • Contributors AE and MM drafted the manuscript. LU, ET and RI revised the manuscript for intellectual content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    Linked Articles

    • General neurology
      Multidisciplinary consensus guideline for the diagnosis and management of spontaneous intracranial hypotension
      Sanjay Cheema Jane Anderson Heather Angus-Leppan Paul Armstrong David Butteriss Lalani Carlton Jones David Choi Amar Chotai Linda D'Antona Indran Davagnanam Brendan Davies Paul J Dorman Callum Duncan Simon Ellis Valeria Iodice Clare Joy Susie Lagrata Sarah Mead Danny Morland Justin Nissen Jenny Pople Nancy Redfern Parag P Sayal Daniel Scoffings Russell Secker Ahmed K Toma Tamsin Trevarthen James Walkden Jürgen Beck Peter George Kranz Wouter Schievink Shuu-Jiun Wang Manjit Singh Matharu
      Journal of Neurology, Neurosurgery & Psychiatry 2023; 94 835-843 Published Online First: 05 May 2023. doi: 10.1136/jnnp-2023-331166