Spontaneous intracranial hypotension (SIH) is a rare neurological condition caused by low cerebrospinal fluid (CSF) volume, most commonly due to a CSF leak. The most common presenting symptom is an orthostatic headache, but some patients may present with atypical neurological manifestations such as cranial nerve palsies, an altered mental status, and movement disorders, which complicate the clinical diagnosis. Therefore, the diagnosis is based on the combination of clinical signs and symptoms, neuroimaging, and/or a low cerebrospinal fluid pressure. In this review, we describe the wide variety of neurological manifestations and complications seen in patients with SIH as well as the most common features described on imaging studies, including both subjective and objective measurements, in order to lead the clinician to a correct diagnosis. The prompt and correct management of patients with SIH will help prevent the development of life-threatening complications, such as subdural hematomas, cerebral venous thrombosis, and coma, and avoid unnecessary invasive procedures.

中文翻译：

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自发性颅内低血压：一种经常被误诊的疾病的关键特征。

自发性颅内低血压 (SIH) 是一种罕见的神经系统疾病，由低脑脊液 (CSF) 量引起，最常见的原因是脑脊液漏。最常见的症状是直立性头痛，但部分患者可能出现不典型的神经系统表现，如颅神经麻痹、精神状态改变和运动障碍，使临床诊断复杂化。因此，诊断基于临床体征和症状、神经影像学和/或低脑脊液压力的组合。在这篇综述中，我们描述了 SIH 患者的各种神经系统表现和并发症，以及影像学研究中描述的最常见特征，包括主观和客观测量，以引导临床医生做出正确的诊断。