1/5. Spontaneous intracranial hypotension with diffuse dural enhancement of the spinal canal and transient enlargement of the pituitary gland.Spontaneous intracranial hypotension is a rare phenomenon characterized by postural headache, neck rigidity, nausea and vomiting. Imaging findings on magnetic resonance imaging (MRI) is characteristic with diffuse intracranial pachymeningeal thickening and enhancement following intravenous gadolinium. We present a case of spontaneous intracranial hypotension with two unusual imaging findings; pachymeningeal enhancement of the spinal canal and enlargement of the pituitary gland in addition to the diffuse intracranial pachymeningeal enhancement. In this case report, we will discuss the clinical features, MRI findings and underlying pathophysiology of this rare condition.- - - - - - - - - - ranking = 1keywords = pituitary gland, pituitary, gland (Clic here for more details about this article) |
2/5. Bilateral subdural effusion and cerebral displacement associated with spontaneous intracranial hypotension: diagnostic and management strategies. Report of two cases.The authors describe two patients with bilateral subdural effusion and cerebral displacement associated with spontaneous intracranial hypotension (SIH) and discuss the possible pathophysiological origins of these abnormalities. The signs seen on magnetic resonance imaging in both cases, such as tonsillar descent, subdural effusion, meningeal enhancement, downward displacement of the optic chiasm, and crowding of this structure and the hypothalamus between the pituitary gland and brain, can help to establish the diagnosis of SIH. Therapy with a lumbar epidural blood patch resulted in the rapid resolution of all symptoms and most morphological abnormalities. The authors propose diagnostic and management strategies based on their own experiences and the reported cases of SIH in the medical literature.- - - - - - - - - - ranking = 0.2keywords = pituitary gland, pituitary, gland (Clic here for more details about this article) |
3/5. Spontaneous intracranial hypotension: morphological findings and CSF flow dynamics studied by MRI.We report on a case of spontaneous intracranial hypotension (SIH) presenting with classic MR findings, such as diffuse smooth thickening and intense contrast enhancement of the dura matter, increased size of the pituitary gland and downward displacement of the brain. In this case an engorgement of the cavernous sinuses is reported as an additional imaging finding of SIH. Moreover, phase-contrast MR study of the CSF flow dynamics revealed at the level of the aqueduct a decrease of the systolic and diastolic flow volume of CSF. A normalization of the flow volume was observed when SIH subsided.- - - - - - - - - - ranking = 0.2keywords = pituitary gland, pituitary, gland (Clic here for more details about this article) |
4/5. Spontaneous intracranial hypotension with pituitary adenoma.Spontaneous intracranial hypotension (SIH) is an unusual syndrome that is characterised by positional headache, neck rigidity, nausea and vomiting. The characteristic magnetic resonance imaging (MRI) findings are diffuse smooth pachymeningeal thickening and enhancement, downward displacement of posterior fossa structures and pituitary gland enlargement. An unusual case of SIH with pituitary macro-adenoma and subsequent subdural haemorrhage is presented, and its clinical picture, MRI findings and possible pathophysiological mechanism are discussed.- - - - - - - - - - ranking = 0.21893482366251keywords = pituitary gland, pituitary, gland (Clic here for more details about this article) |
5/5. Seizure as a manifestation of intracranial hypotension in a shunted patient.The authors describe a child with a ventriculo-peritoneal shunt in place for 5 years who presented with 'postural' seizures (seizures on sitting upright, which resolved on recumbency). On shunt tap, the cerebrospinal fluid was obtained freely, but required gentle aspiration with a syringe in the recumbent position, suggesting very low intracranial pressure. Contrast magnetic resonance imaging showed pachymeningeal enhancement and enlargement of the pituitary gland diagnostic of intracranial hypotension along with well-decompressed ventricles. At the time of revision of the shunt, no evidence of malfunction was found and the valve was changed to one with a higher opening pressure. Following this, she became asymptomatic and seizure free. This case illustrates the fact that following shunting, intracranial hypotension may also predispose to seizures, and should be kept in mind while managing these patients.- - - - - - - - - - ranking = 0.2keywords = pituitary gland, pituitary, gland (Clic here for more details about this article) |