Background and purpose

An intraspinal fluid collection (ISFC) can be observed on spinal MRI in cases of intracranial hypotension syndrome (IHS). The goal of this study was to analyze the possible persistence of ISFC after therapy and its correlation to clinical disease activity and secondary complications.

Materials and methods

Twenty patients in our database of 57 patients, who were treated for IHS between 2009 and 2015, fulfilled the inclusion criteria of (a) diagnosed and treated IHS as well as (b) an ISFC in MRI imaging. Ten of these participated in our study. We performed follow-up visits, which included a history, a clinical examination, and a spinal MRI.

Results

A MRI-confirmed ISFC was seen in six patients, five of which had symptoms attributable to chronic IHS. There were two cases of superficial siderosis. One patient had a persisting ISFC and was free of symptoms. Four patients did not have an ISFC and were free of symptoms (Fisher’s exact test; p < 0.048).

Conclusion

There is statistically significant correlation between the persistence of an ISFC after IHS treatment and ongoing clinical symptoms. Resolved symptoms seem to correlate with absorbed extradural ISFC and hypothetically closed leakage site. ISFC as confirmed by MRI proofs to be a reliable follow-up marker for disease activity in chronic IHS that is possibly even superior to clinical examination.

中文翻译：

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脊髓内积液的持续性和复发性决定了颅内低血压综合征的症状控制。

背景和目的

在颅内低血压综合征 (IHS) 的情况下，可以在脊髓 MRI 上观察到脊髓内积液 (ISFC)。本研究的目的是分析治疗后 ISFC 可能持续存在及其与临床疾病活动和继发性并发症的相关性。

材料和方法

我们数据库中的 57 名患者中的 20 名患者在 2009 年至 2015 年间接受了 IHS 治疗，符合 (a) 诊断和治疗的 IHS 以及 (b) MRI 成像中的 ISFC 的纳入标准。其中十人参与了我们的研究。我们进行了随访，包括病史、临床检查和脊柱 MRI。

结果

6 名患者出现 MRI 证实的 ISFC，其中 5 名患者出现慢性 IHS 症状。有两例表面铁质沉着症。一名患者持续存在 ISFC，并且没有任何症状。四名患者没有 ISFC 并且没有症状（Fisher 精确检验；p  < 0.048）。

结论

IHS 治疗后 ISFC 的持续存在与持续的临床症状之间存在统计学显着相关性。已解决的症状似乎与吸收的硬膜外 ISFC 和假设的闭合渗漏部位相关。ISFC 经 MRI 证明是慢性 IHS 疾病活动的可靠随访标志物，甚至可能优于临床检查。