Cornell University
Library
Cornell UniversityLibrary

eCommons

Help
Log In(current)
  1. Home
  2. Weill Cornell Medicine
  3. Medical College Research and Papers
  4. Department of Medicine
  5. CSF pressures in spontaneous intracranial hypotension due to CSF-venous fistula: A retrospective analysis

CSF pressures in spontaneous intracranial hypotension due to CSF-venous fistula: A retrospective analysis

File(s)
40992352.pdf (1.91 MB)
No Access Until
2026-09-22
Permanent Link(s)
https://hdl.handle.net/1813/121523
Collections
Department of Medicine
Author
McRae-Posani, B.
Strauss, S.
Robbins, M.S.
Salama, G.
Abstract

OBJECTIVE: To report CSF pressure (P${csf}$) and its correlations in patients with SIH due to CSF-venous fistula (CVF). METHODS: Following IRB approval, consecutive SIH patients undergoing myelography between 2021 and 2025 at a single center were retrospectively analyzed. P${csf}$ was defined as opening pressure (OP) during myelography, with patient in decubitus positioning with mild hip elevation. Low OP was defined as < 6 cm H$2$O; elevated OP as > 20 cm H$2$O. RESULTS: Of the 86 SIH patients analyzed, 35 (41 %) had a CVF [average age 59 ± 13; 12/35 (34 %) male; 23/35 (66 %) female]. Of the 35, OP was reported for 32 patients. The mean ± SD OP was 13.97 ± 3.91 cm H$2$O (range: 6-25 cm H$2$O). None (0 %) of the patients had low OP. 29/32 (91 %) had OP in normal range, 3/32 (9 %) had elevated OP. P${csf}$ was positively correlated with BMI (p = 0.045); but not correlated with age, sex, prior epidural blood patching, symptom duration, or mean arterial pressure. High variability in P${csf}$ values was not fully accounted for by predictors included in our model (pseudo-R$^2$ = 0.188). CONCLUSIONS: An absence of low P${csf}$ should not be used to rule out SIH, as all our patients with SIH due to CVF had normal or elevated P${csf}$. Such P${csf}$ readings in patients with active CSF leaks suggest that the development of CVF and post-treatment rebound headaches may be due to pre-existing intracranial hypertension. While BMI is positively correlated with P${csf}$, limited explanatory power of our model suggests influence of other factors.

Journal / Series
Clinical neurology and neurosurgery
Volume & Issue
258
Date Issued
2025-09-22
Publisher
Elsevier
Keywords
WCM Library Coordinated Deposit
•
Humans
•
Male
•
Female
•
Intracranial Hypotension/etiology/physiopathology/diagnostic imaging
•
Middle Aged
•
Retrospective Studies
•
Cerebrospinal Fluid Pressure/physiology
•
Aged
•
Adult
•
Myelography
•
Cerebrospinal Fluid Leak/complications
•
CSF Opening Pressure
•
CSF Pressure
•
CSF-Venous Fistula
•
Headache
•
Sih
•
Spontaneous Intracranial Hypotension
Related DOI
https://doi.org/10.1016/j.clineuro.2025.109169
Previously Published as
McRae-Posani B, Strauss S, Robbins MS, Salama G. CSF pressures in spontaneous intracranial hypotension due to CSF-venous fistula: A retrospective analysis. Clinical neurology and neurosurgery. 2025;258:109169. doi: 10.1016/j.clineuro.2025.109169. PMID: 40992352.
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
Rights URI
https://creativecommons.org/licenses/by-nc-nd/4.0/
Type
article

Site Statistics | Help

About eCommons | Policies | Terms of use | Contact Us

copyright © 2002-2026 Cornell University Library | Privacy | Web Accessibility Assistance