Diagnostic Criteria for Spontaneous Spinal CSF Leaks and Intracranial Hypotension

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Authors: W.I. Schievinka, M.M. Mayab, C. Louyc,  F.G. Moserb and J. Tourjeb

Abstract

BACKGROUND AND PURPOSE: Comprehensive diagnostic criteria encompassing the varied clinical and radiographic manifestations of spontaneous intracranial hypotension are not available. Therefore, we propose a new set of diagnostic criteria.

MATERIALS AND METHODS: The diagnostic criteria are based on results of brain and spine imaging, clinical manifestations, results of lumbar puncture, and response to epidural blood patching. The diagnostic criteria include criterion A, the demonstration of extrathecal CSF on spinal imaging. If criterion A is not met, criterion B, which is cranial MR imaging findings of spontaneous intracranial hypotension, follows, with at least one of the following: 1) low opening pressure, 2) spinal meningeal diverticulum, or 3) improvement of symptoms after epidural blood patch. If criteria A and B are not met, there is criterion C, the presence of all of the following or at least 2 of the following if typical orthostatic headaches are present: 1) low opening pressure, 2) spinal meningeal diverticulum, and 3) improvement of symptoms after epidural blood patch. These criteria were applied to a group of 107 consecutive patients evaluated for spontaneous spinal CSF leaks and intracranial hypotension.

RESULTS: The diagnosis was confirmed in 94 patients, with use of criterion A in 78 patients, criterion B in 11 patients, and criterion C in 5 patients.

CONCLUSIONS: A new diagnostic scheme is presented reflecting the wide spectrum of clinical and radiographic manifestations of spontaneous spinal CSF leaks and intracranial hypotension.

Copyright © American Society of Neuroradiology

Read more here: http://www.ajnr.org/content/29/5/853

Stone runner takes on London Marathon raising cash to pay for US treatment

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A TEACHER suffering a debilitating brain condition who launched a fund-raising campaign to pay for treatment abroad has been overwhelmed by offers of help from residents.

Former marathon runner Claire Hubbard, 47, from Eccleshall, has been inundated with calls from people rushing to help her raise the £13,000 needed for treatment in the USA.

The mum-of-two, who taught at St Michael’s First School for much of her 26-year teaching career, suffers with intracranial hypotension, which causes brain or spinal fluid to leak. It means her life has changed dramatically and she has gone from running marathons to having to use a wheelchair to get around. She has a constant headache, has to lie down regularly and suffers body jerks and spasms.

She was diagnosed after a long battle to get medics to believe her and the treatment in America involves scanning the brain to find out exactly where the leak is so it can be treated.

Read more: http://www.staffordshirenewsletter.co.uk/Stone-runner-takes-London-Marathon-ill-Eccleshall/story-20854480-detail/story.html#ixzz2xC1cq8qR

Stone mum bidding to raise cash for brain treatment in the USA with the help of pupils

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GENEROUS Stone pupils and the family of a teacher suffering a debilitating brain condition have launched a major fund-raising campaign to pay for treatment abroad. Former marathon runner Claire Hubbard, 47, who lives in Eccleshall, used to work at St Michael’s First School in Stone.

Her identical twin sister Louise Walmsley is also a teacher at St Michael’s.

But four years ago the mum-of-two began suffering excruciating headaches and collapsed on the floor.She spent much of 2010 having to lie down and was in and out of hospital having tests to find the cause of her pain.

As a result she began suffering with Postural Ortho Static Tachycardia Syndrome, which causes fainting and light-headedness. She has struggled to stand up without her body jerking or suffering a seizure.

Read more: http://www.staffordshirenewsletter.co.uk/undefined-headline/story-20803344-detail/story.html#ixzz2wp1tLDDu

Family launch £13k appeal to send Eccleshall mum to U.S. for life-changing op

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DESPERATELY-ILL Claire Hubbard’s family have launched a fund-raising appeal to help pay for a life-changing operation in the U.S. – to stop her brain from ‘sinking’.

The 47-year-old’s condition has baffled doctors in this country and her only hope is to meet with experts overseas.

Now she needs to raise £13,000 to cover the cost of a specialist brain scan and treatment.

Read more: http://www.stokesentinel.co.uk/Family-launch-pound-13k-appeal-send-Eccleshall/story-20825954-detail/story.html#ixzz2wp0hIvtz