Purpose of Review

To provide an update on recent developments in the understanding, diagnosis, and treatment of CSF-venous fistula (CVF).

Recent Finding

CVF is a recently recognized cause of spontaneous intracranial hypotension (SIH), an important secondary headache, in which an aberrant connection is formed between the spinal subarachnoid space and an adjacent spinal epidural vein permitting unregulated loss of CSF into the circulatory system. CVFs often occur without a concurrent epidural fluid collection; therefore, CVF should be considered as a potential etiology for patients with SIH symptomatology but without an identifiable CSF leak. Imaging plays a critical role in the detection and localization of CVFs, with a number of imaging techniques and provocative maneuvers described in the literature to facilitate their localization for targeted and definitive treatment.

Summary

Increasing awareness and improving the localization of CVFs can allow for improved outcomes in the SIH patient population. Future prospective studies are needed to determine the diagnostic performance of currently available imaging techniques as well as their ability to inform workup and guide treatment decisions.

中文翻译：

---

CSF-静脉瘘

审查目的

提供对脑脊液静脉瘘 (CVF) 的理解、诊断和治疗的最新进展。

最近的发现

CVF 是最近公认的自发性颅内低血压 (SIH) 的原因，SIH 是一种重要的继发性头痛，其中脊髓蛛网膜下腔和相邻的硬脊膜外静脉之间形成异常连接，导致 CSF 不受控制地流失到循环系统中。CVF 经常在没有同时收集硬膜外积液的情况下发生；因此，对于有 SIH 症状但没有可识别的脑脊液漏的患者，CVF 应被视为潜在的病因。成像在 CVF 的检测和定位中起着至关重要的作用，文献中描述了许多成像技术和刺激性操作，以促进其定位以进行靶向和确定性治疗。

概括

提高认识和改进 CVF 的定位可以改善 SIH 患者群体的结果。需要未来的前瞻性研究来确定当前可用成像技术的诊断性能以及它们为检查提供信息和指导治疗决策的能力。