A MULTIMODAL APPROACH TO DIAGNOSING AND VERIFYING THE CAUSE OF
SPONTANEOUS INTRACRANIAL HYPOTENSION
Zyablova D.D.1,2, Zyablova E.I.1,2, Gvazava V.R.1,2
1 - Scientific Research Institute, S.V. Ochapovsky Regional Clinical Hospital No.1.
2 - Kuban State Medical University. Krasnodar, Russia.
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urpose. To demonstrate the usefulness and importance of a diagnostic algorithm and a multimodal approach in finding the cause of spontaneous intracranial hypotension (SIH).
Materials and methods. A clinical case of a female patient with progressive headache is presented. To determine the cause of the headache, an algorithm for patients with non-traumatic intracranial hemorrhages was used. This algorithm revealed a non-traumatic subdural hematoma (nSDH) and ruled out a vascular cause. Magnetic resonance imaging (MRI) with contrast revealed signs of intracranial hypotension, and subsequent computed tomography (CT) of the spine and CT-myelography determined the location of the cerebrospinal fluid leak.
Results. CT and MRI studies revealed the cause of the patient's progressive headache –spontaneous intracranial hypotension – and also identified the location of the cerebrospinal fluid leak. Following these studies, the patient underwent successful surgery.
Discussion. The diagnosis of SDH, previously considered rare, is now much more common. In-sufficient awareness among specialists of modern techniques capable of verifying the location of a cerebrospinal fluid leak remains a problem.
Conclusion. For successful treatment of patients, adherence to diagnostic algorithms and a multi-modal approach is necessary.
Keywords: computed tomography (CT), CT angiography, magnetic resonance imaging (MRI), spontaneous intracranial hypotension (SIH), cerebrospinal fluid dynamics.
Corresponding author: Zyablova D.D., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Zyablova D.D., Zyablova E.I., Gvazava V.R. A multimodal approach to diagnosing and verifying the cause of spontaneous intracranial hypotension. REJR 2025; 15(4):259-269. DOI: 10.21569/2222-7415-2025-15-4-259-269.
Received: 13.11.25 Accepted: 11.12.25