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Spontaneous Intracranial Hypotension May Be an Under-recognized Cause of Endolymphatic Hydrops.
Published Web Locationhttps://doi.org/10.1097/mao.0000000000002665
ObjectiveWe describe three rare cases of spontaneous intracranial hypotension (SIH) presenting with symptoms of endolymphatic hydrops (EH) and perform a literature review to bring attention to a rare link between SIH and EH.
PatientA 59-year-old female presented with postural headache, aural fullness, vertigo, hearing loss, and abnormal electrocochleography after being diagnosed with SIH by magnetic resonance imaging. The site of cerebrospinal fluid leak was identified in this individual. Two additional patients with vertigo, hearing loss, and SIH were identified by retrospective chart review.
InterventionAll patients underwent blood patches. One patient also had diuretic treatment while another had fibrin glue injection.
Main outcome measuresThe outcomes of interest were resolution of headache, vertigo, aural fullness, and hearing loss.
ResultsAll patients eventually improved with time. Literature review suggests that overall outcome is excellent.
ConclusionsSIH may be an under-recognized cause of EH. We support the theory that negative intracranial pressure transmitted through the cochlear aqueduct and perilymph leads to EH. Despite the variations in treatments, the overall prognosis is excellent.
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