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Mri findings in lumbar puncture headache syndrome

Abnormal dural-meningeal and dural venous sinus enhancement
  • Rohit Bakshi
    Correspondence
    Address correspondence to: Rohit Bakshi, MD, Neuroscience Center E-2, 100 High St., Buffalo, NY 14203
    Affiliations
    University at Buffalo (SUNY) School of Medicine and Biomedical Sciences, Buffalo, NY, Departments of Neurology, Neuroimaging, Lucy Dent Imaging Center, Buffalo, NY, and Kaleida Health-Millard Fillmore Gates Circle Hospital, Buffalo, NY USA
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  • Laszlo L Mechtler
    Affiliations
    University at Buffalo (SUNY) School of Medicine and Biomedical Sciences, Buffalo, NY, Departments of Neurology, Neuroimaging, Lucy Dent Imaging Center, Buffalo, NY, and Kaleida Health-Millard Fillmore Gates Circle Hospital, Buffalo, NY USA
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  • Saadat Kamran
    Affiliations
    University at Buffalo (SUNY) School of Medicine and Biomedical Sciences, Buffalo, NY, Departments of Neurology, Neuroimaging, Lucy Dent Imaging Center, Buffalo, NY, and Kaleida Health-Millard Fillmore Gates Circle Hospital, Buffalo, NY USA
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  • Eugene Gosy
    Affiliations
    University at Buffalo (SUNY) School of Medicine and Biomedical Sciences, Buffalo, NY, Departments of Neurology, Neuroimaging, Lucy Dent Imaging Center, Buffalo, NY, and Kaleida Health-Millard Fillmore Gates Circle Hospital, Buffalo, NY USA
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  • Vernice E Bates
    Affiliations
    University at Buffalo (SUNY) School of Medicine and Biomedical Sciences, Buffalo, NY, Departments of Neurology, Neuroimaging, Lucy Dent Imaging Center, Buffalo, NY, and Kaleida Health-Millard Fillmore Gates Circle Hospital, Buffalo, NY USA
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  • Peter R Kinkel
    Affiliations
    University at Buffalo (SUNY) School of Medicine and Biomedical Sciences, Buffalo, NY, Departments of Neurology, Neuroimaging, Lucy Dent Imaging Center, Buffalo, NY, and Kaleida Health-Millard Fillmore Gates Circle Hospital, Buffalo, NY USA
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  • William R Kinkel
    Affiliations
    University at Buffalo (SUNY) School of Medicine and Biomedical Sciences, Buffalo, NY, Departments of Neurology, Neuroimaging, Lucy Dent Imaging Center, Buffalo, NY, and Kaleida Health-Millard Fillmore Gates Circle Hospital, Buffalo, NY USA
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      Abstract

      Intracranial hypotension (IH) is a treatable cause of persistent headaches. Persistent cerebrospinal fluid (CSF) leak at a lumbar puncture (LP) site may cause IH. We present postcontrast MRI of a patient with post-lumbar-puncture headache (LPHA) showing abnormal, intense, diffuse, symmetric, contiguous dural-meningeal (pachymeningeal) enhancement of the supratentorial and infratentorial intracranial dura, including convexities, interhemispheric fissure, tentorium, and falx. MRI also showed abnormal dural venous sinus enhancement, a new finding in LPHA, suggesting compensatory venous expansion. Thus, IH and venodilatation may play a role in the development of LPHA.

      Keywords

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