SPINAL DURAL ENHANCEMENT ON MAGNETIC-RESONANCE-IMAGING ASSOCIATED WITH SPONTANEOUS INTRACRANIAL HYPOTENSION - REPORT OF 3 CASES AND REVIEW OF THE LITERATURE

This report offers a description of typical changes seen on gadolinium -enhanced magnetic resonance (MR) imaging of the entire spine that ind icate spontaneous intracranial hypotension (SIH). To the authors' know ledge, this is the first report of its kind. They describe three cases of SIH that were accompanied by dural enhancement throughout the neur axis on imaging, with the evolution of associated subdural and epidura l fluid collections in the spine. Recognition of this disorder is impo rtant to be able to distinguish it from an infectious or neoplastic pr ocess in which surgical intervention might be war ranted. Evaluation u sing gadolinium-enhanced cranial and spinal MR imaging in patients wit h postural headaches and an In-111-labeled cerebrospinal fluid leak st udy are discussed. Treatment with an epidural blood patch is shown to be particularly effective. with resolution of the radiological and cli nical findings.