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Frequency of spontaneous intracranial hypotension in the emergency department

The Journal of Headache and Pain volume 8, pages 325–328 (2007)Cite this article

Abstract

Spontaneous intracranial hypotension is considered a rare disorder. We conducted a study on the frequency of spontaneous intracranial hypotension in the emergency department (ED). We identified patients with spontaneous intracranial hypotension evaluated in the ED of a large urban hospital between 1 January 2003 and 31 December 2006. For comparison, we also identified all patients with spontaneous subarachnoid haemorrhage (SAH). Eleven patients with previously undiagnosed spontaneous intracranial hypotension were evaluated in the ED during the four-year time period. All patients presented with positional headaches and the duration of symptoms varied from one day to three months. None of the patients were correctly diagnosed with spontaneous intracranial hypotension in the ED. During the same time period, 23 patients with aneurysmal SAH were evaluated. Spontaneous intracranial hypotension is more common than previously appreciated and the diagnosis in the ED remains problematic.

References

  1. Schievink WI (2006) Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. JAMA 295:2286–2296, 10.1001/jama.295.19.2286, 1:CAS:528:DC%2BD28Xksl2rsr8%3D, 16705110

    Article  CAS  PubMed  Google Scholar 

  2. Schievink WI (2003) Misdiagnosis of spontaneous intracranial hypotension. Arch Neurology 60:1713–1738, 10.1001/archneur.60.12.1713

    Article  Google Scholar 

  3. Brown RD, Whisnant JP, Sicks JD, et al (1996) Stroke incidence, prevalence, and survival: secular trends in Rochester, Minnesota, through 1989. Stroke 27:370–372

    Article  Google Scholar 

  4. Schievink WI, Morreale VM, Atkinson JL et al (1998) Surgical treatment of spontaneous spinal cerebrospinal fluid leaks. J Neurosurg 88:243–246, 10.3171/jns.1998.88.2.0243,1:STN:280:DyaK1c7ht1Kisg%3D%3D, 9452231

    Article  CAS  PubMed  Google Scholar 

  5. Leicht M (1980) Non-traumatic headache in the emergency department. Ann Emerg Med 9:404–409, 10.1016/S0196-0644(80)80152-1,1:STN:280:DyaL3c3mtlKitQ%3D%3D,6996537

    Article  CAS  PubMed  Google Scholar 

  6. Barton CW (1994) Evaluation and treatment of headache patients in the emergency department: A survey. Headache 34:91–94, 10.1111/j.1526-4610.1994.hed3402091.x, 1:STN:280:DyaK2c3hs1Whtg%3D%3D, 8163373

    Article  CAS  PubMed  Google Scholar 

  7. Morgenstern LB, Huber JC, Luna-Gonzales H et al (2001) Headache in the Emergency Department. Headache 41:537–541, 10.1046/j.1526-4610.2001.041006537.x, 1:STN:280:DC%2BD38%2FhvFKguw%3D%3D, 11437887

    Article  CAS  PubMed  Google Scholar 

  8. Locker T, Mason S, Rigby A (2004) Headache management—Are we doing enough? An observational study of patients presenting with headache to the emergency department. Emerg Med J 21:327–332, 10.1136/emj.2003.012351, 1:STN:280:DC%2BD2c3gvFGrsg%3D%3D, 15107372

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Goldstein JN, Camargo CA Jr, Pelletier AJ, Edlow JA (2006) Headache in United States emergency departments: demographics, work-up and frequency of pathological diagnoses. Cephalalgia 26:684–690, 10.1111/j.1468-2982.2006.01093.x,1:STN:280:DC%2BD28zntFahsA%3D%3D, 16686907

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, The Maxine Dunitz Neurosurgical Institute, Cedars-Sinai Medical Center, 8631 West Third Street, Suite 800E, Los Angeles, CA, 90048, USA

    Wouter I. Schievink

  2. Imaging Medical Group, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    M. M. Maya, Franklin Moser & James Tourje

  3. Department of Emergency Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Sam Torbati

Authors
  1. Wouter I. Schievink
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  2. M. M. Maya
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  3. Franklin Moser
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  4. James Tourje
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  5. Sam Torbati
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Corresponding author

Correspondence to Wouter I. Schievink.

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Open Access This is an open access article distributed under the terms of the Creative Commons Attribution Noncommercial License ( https://creativecommons.org/licenses/by-nc/2.0 ), which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

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Schievink, W.I., Maya, M.M., Moser, F. et al. Frequency of spontaneous intracranial hypotension in the emergency department. J Headache Pain 8, 325–328 (2007). https://doi.org/10.1007/s10194-007-0421-8

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  • DOI: https://doi.org/10.1007/s10194-007-0421-8

Keywords

  • Emergency medicine
  • Epidemiology
  • Headache
  • Intracranial hypotension

The Journal of Headache and Pain

ISSN: 1129-2377

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