Cervical MRI Findings in Intracranial Hypotension

Intracranial hypotension is characterised by a fall in intracranial pressure presenting clinically with postural headache and cervical pain. The syndrome may arise after lumbar puncture, surgery, trauma, severe dehydration or spontaneously. We studied two patients with intracranial hypotension presenting hallmark intracranial MR features of the syndrome with different involvement of the cervical spine in terms of MR features and clinical presentation and course. MR imaging of the cervical and dorsal spine in both patients was carried out using T1, T2 and T2-FLAIR weighted sagittal spin echo sequences and T2 weighted axial turbo spin echo (TSE) sequences. In the first patient, MR disclosed an area of altered signal intensity within the cerebral canal in an extradural, anterior and lateral location both right and left, symmetrical with craniocaudal extension from C1 to D2. The area was strongly hyperintense in T2-FLAIR sequences compressing the anterolateral surface of the dura mater and was ascribed to an ...