MRI findings in lumbar puncture headache syndrome: Abnormal dural-meningeal and dural venous sinus enhancement

Intracranial hypotension (IH) is a treatable cause of persistent headaches. Persistent cerebrospinal fluid (CSF) leak at a lumbar puncture (LP) site m ay cause IH. We present postcontrast MRI of a patient with post-lumbar-punc ture headache (LPHA) showing abnormal, intense, diffuse, symmetric, contigu ous dural-meningeal (pachymeningeal) enhancement of the supratentorial and infratentorial intracranial dura, including convexities, interhemispheric f issure, tentorium, and fair. MRI also showed abnormal dural venous sinus en hancement, a new finding in LPHA, suggesting compensatory venous expansion. Thus, IH and venodilatation may play a role in the development of LPHA. (C ) Elsevier Science Inc., 1999.