NEUROVISUAL FINDINGS IN THE SYNDROME OF SPONTANEOUS INTRACRANIAL HYPOTENSION FROM DURAL CEREBROSPINAL-FLUID LEAK

Background: Spontaneous intracranial hypotension has been considered a rare clinical entity, with less than 75 cases reported in the medical literature. With the advent of magnetic resonance imaging (MRI), spon taneous intracranial hypotension currently is being recognized more fr equently. The authors report the neurovisual manifestations of this di sorder in a consecutive series of three patients. Methods: Each patien t underwent clinical examination, computerized visual field testing, a nd MRI. After treatment, each patient was re-examined, and MRI was rep eated. Results: Two patients had transient visual obscurations and unu sual binasal visual field defects on automated perimetry. A third pati ent had diplopia from an abducens nerve paresis. After treatment of sp ontaneous intracranial hypotension, these findings improved or resolve d. Conclusions: This case series, and a review of previously reported cases, indicates that neurovisual problems are common in patients with spontaneous intracranial hypotension. Findings may include diplopia f rom sixth nerve paresis, transient visual obscurations, blurred vision , visual field defects, photophobia, and nystagmus.