Postural headache in marfan syndrome associated with spinal cysts and liquor hypotension.

Abstract:

:We here report a 13-year-old Marfan patient who suffered from severe, medication-resistant, intermittent headache, which was provoked when getting into an upright position and immediately relieved by lying down or after intravenous rehydration. The postural benefit and the sudden relief after intravenous hydration suggested (intermittent) intracranial hypotension, although a normal opening pressure on lumbar punction was observed and no cerebrospinal fluid (CSF) leakage was identified. Imaging studies revealed severe dural ectasia at lumbosacral level, and two intradural cysts and two extradural presacral cysts were detected. Most likely, altered hydrodynamics in intra- and extracranial spinal meningeal cysts caused intermittent CSF hypotension above these cysts, resulting in intermittent intracranial hypotension. Surgical marsupialisation of the intradural cysts proved to be effective. This resulted in a significant reduction of the headache during the clinical follow-up of eight years.

journal_name

Neuropediatrics

journal_title

Neuropediatrics

authors

Voermans NC,Dijk KG,Bos MM,Geus-Oei LF,Verrips A,Lindert EJ

doi

10.1055/s-0029-1243164

subject

Has Abstract

pub_date

2009-08-01 00:00:00

pages

201-4

issue

4

eissn

0174-304X

issn

1439-1899

journal_volume

40

pub_type

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