Artículos científicos

CONSENSOS

Diagnóstico y tratamiento de los trastornos de la presión intracraneal: Documento de consenso del Grupo de Estudio de Cefaleas de la Sociedad Española de Neurología

García-Ull, N. González-García, M. Torres-Ferrús, D. García-Azorín, I.F.J. Molina-Martínez, I. Beltrán-Blasco, S. Santos-Lasaosa, G. Latorre, A.B. Gago-Veiga, J.M. Láinez, J. Porta-Etessam, C. Nieves-Castellanos, A. Mínguez-Olaondo, A. López-Bravo, S. Quintasⁱ, N. Morollón, S. Díaz-Insa, R. Belvís, P. Diagnóstico y tratamiento de los trastornos de la presión intracraneal: Documento de consenso del Grupo de Estudio de Cefaleas de la Sociedad Española de Neurología. Elsevier.
Vol. 40. Núm. 1. Páginas 118-137 (Enero-Febrero 2025) DOI: 10.1016/j.nrl.2023.06.003

Consensus Guidelines on Diagnostic Brain and Spine Imaging of Spontaneous Intracranial Hypotension

Kranz PG, Amrhein TJ, Brinjikji W, Callen AL, Carroll I, Chazen JL, Cutsforth-Gregory J, Friedman DI, Hutchins TA, Lehman VT, Madhavan AA, Mamlouk MD, Mark IT, Maya MM, Moser FG, Parikh SK, Schievink WI, Shah LM, Shah VN, Thaker AA, Jordan JE. Consensus Guidelines on Diagnostic Brain and Spine Imaging of Spontaneous Intracranial Hypotension. AJNR Am J Neuroradiol. 2025 Dec 4;46(12):2457-2467. DOI: https://doi.org/10.3174/ajnr.A9017

Multidisciplinary consensus guideline for the diagnosis and management of spontaneous intracranial hypotension

Cheema S, Anderson J, Angus-Leppan H, Armstrong P, Butteriss D, Carlton Jones L, Choi D, Chotai A, D'Antona L, Davagnanam I, Davies B, Dorman PJ, Duncan C, Ellis S, Iodice V, Joy C, Lagrata S, Mead S, Morland D, Nissen J, Pople J, Redfern N, Sayal PP, Scoffings D, Secker R, Toma AK, Trevarthen T, Walkden J, Beck J, Kranz PG, Schievink W, Wang SJ, Matharu MS. Multidisciplinary consensus guideline for the diagnosis and management of spontaneous intracranial hypotension. J Neurol Neurosurg Psychiatry. 2023 Oct;94(10):835-843. DOI:10.1136/jnnp-2023-331166

2026

"Getting to diagnosis was an absolute nightmare”: survey insights about the lived experience of spinal CSF leak in Australia and Aotearoa New Zealand

Knight, L.S.W., Smith, R.L., Britten-Jones, A.C. et al. “Getting to diagnosis was an absolute nightmare”: survey insights about the lived experience of spinal CSF leak in Australia and Aotearoa New Zealand. J Neurol 273, 300 (2026). https://doi.org/10.1007/s00415-026-13840-y

The Diagnostic Burden of Spontaneous Intracranial Hypotension: Imaging Volume and Specialists’ Involvement Prior to Diagnosis

Parnian Habibi, Jared Verdoorn, Ajay A. Madhavan, John Benson, Waleed Brinjikji, Ben Johnson-Tesch, Chelsea Dahl, Jeremy Cutsforth-Gregory, Ian T. Mark. The Diagnostic Burden of Spontaneous Intracranial Hypotension: Imaging Volume and Specialists’ Involvement Prior to Diagnosis. American Journal of Neuroradiology Feb 2026, DOI: https://doi.org/10.3174/ajnr.A9012

Is headache always necessary for the diagnosis of rebound intracranial hypertension in patients successfully treated for cerebrospinal fluid venous fistula?

Kinsara R, Kapadia A, Meng H. Is headache always necessary for the diagnosis of rebound intracranial hypertension in patients successfully treated for cerebrospinal fluid venous fistula? Headache. 2026 Apr 3. doi: 10.1111/head.70088

Does change of spinal diverticular size predict the site of de novo recurrent CSF-venous fistulas in patients with spontaneous intracranial hypotension?

Schievink WI, Maya MM, Taché RB, Prasad RS, Wadhwa V, Moser FG. Does change of spinal diverticular size predict the site of de novo recurrent CSF-venous fistulas in patients with spontaneous intracranial hypotension? AJNR Am J Neuroradiol. 2026 Feb 23:ajnr.A9258. doi: 10.3174/ajnr.A9258

Sacral Dural Tears in Spontaneous Intracranial Hypotension: Imaging Phenotype and Treatment Outcomes in a Multicenter Cohort

Andrew L. Callen, Daniel Montes, Timothy J. Amrhein, Jürgen Beck, Enrique Barvulsky, Debayan Bhaumik, Andre E. Boyke, Federico Cagnazzo, Lalani Carlton Jones, Tomas Dobrocky, Peter G. Kranz, Peter Lennarson, Ajay Madhavan, Mark D. Mamlouk, Ian T. Mark, Marcel Maya, Eike I. Piechowiak, Wouter Schievink, Florian Volz, Katharina Wolf, Horst Urbach, Niklas Lützen. Sacral Dural Tears in Spontaneous Intracranial Hypotension: Imaging Phenotype and Treatment Outcomes in a Multicenter Cohort. American Journal of Neuroradiology Mar 2026, ajnr.A9297; https://doi.org/10.3174/ajnr.A9297

When Orthostatic Headache Misleads: Positional Headache Phenotypes Across Spinal CSF Leak Types and Implications for Patients Without SIH Findings on Brain MRI

Andrew L. Callen, Kyle Jenkins, Debayan Bhaumik, Kathryn Kerrigan, Meredith Smith, Peter Lennarson. When Orthostatic Headache Misleads: Positional Headache Phenotypes Across Spinal CSF Leak Types and Implications for Patients Without SIH Findings on Brain MRI. American Journal of Neuroradiology May 2026, ajnr.A9421; DOI: https://doi.org/10.3174/ajnr.A9421

Incidence and Predictors of Rebound Intracranial Hypertension after Transvenous Embolization of CSF-Venous Fistulas

Derrek Schartz, Peter G. Kranz, Timothy J. Amrhein, Jay Willhite, Linda Gray, Michael D. Malinzak, Nicholas T. Befera. Incidence and Predictors of Rebound Intracranial Hypertension after Transvenous Embolization of CSF-Venous Fistulas. American Journal of Neuroradiology Apr 2026, DOI: https://doi.org/10.3174/ajnr.A9080

Toward quantifying disability in spontaneous intracranial hypotension: A patient-derived disability weight

Volz F, Omer M, Overstijns M, Rahal AE, Hohenhaus M, Klingler JH, Lützen N, Urbach H, Zander C, Carroll I, Beck J, Wolf K. Toward quantifying disability in spontaneous intracranial hypotension: A patient-derived disability weight. Cephalalgia. 2026 Apr;46(4):3331024261444662. doi: 10.1177/03331024261444662

Surgical Exploration of Radiographically Resolved Spontaneous Ventral Spinal CSF Leaks

Schievink WI, Maya MM, Moser FG, Wadhwa V, Prasad RS. Surgical Exploration of Radiographically Resolved Spontaneous Ventral Spinal CSF Leaks. AJNR Am J Neuroradiol. 2026 Apr 2;47(4):1141-1146. doi: 10.3174/ajnr.A9085

Imaging and physiology across the high–low cerebrospinal fluid pressure spectrum: Navigating diagnostic uncertainty in headache practice

Callen AL, Jenkins K. Imaging and physiology across the high–low cerebrospinal fluid pressure spectrum: Navigating diagnostic uncertainty in headache practice. Headache. 2026; 00: 1-14. doi: 10.1111/head.70096

The relative cost-effectiveness of atraumatic needles compared to conventional needles in diagnostic lumbar punctures

Evans, J., Lowin, J. & Anderson, P. The relative cost-effectiveness of atraumatic needles compared to conventional needles in diagnostic lumbar punctures. Cost Eff Resour Alloc 24, 51 (2026). https://doi.org/10.1186/s12962-025-00612-0.

Enhancing the Characterization of Dural Tears on Photon-Counting CT Myelography: An Analysis of Reconstruction Techniques

Ajay A. Madhavan, Peter G. Kranz, Michelle L. Kodet, Lifeng Yu, Zhongxing Zhou, Timothy J. Amrhein. Enhancing the Characterization of Dural Tears on Photon-Counting CT Myelography: An Analysis of Reconstruction Techniques. American Journal of Neuroradiology Jan 2026, https://doi.org/10.3174/ajnr.A8938

2025

Incidence and Predictors of Rebound Intracranial Hypertension After Transvenous Embolization of Cerebrospinal Fluid-Venous Fistula

Schartz D, Kranz PG, Amrhein TJ, Willhite J, Gray L, Malinzak MD, Befera NT. Incidence and Predictors of Rebound Intracranial Hypertension After Transvenous Embolization of Cerebrospinal Fluid-Venous Fistula. AJNR Am J Neuroradiol. 2025 Nov 6:ajnr.A9080. DOI:10.3174/ajnr.A9080

Patients with chronic post-dural puncture headache do not have typical imaging features of intracranial hypotension: An MRI study using the Bern score

Zander C, Fung C, El Rahal A, Volz F, Wolf K, Rau A, Mast H, Beck J, Urbach H, Lützen N. Patients with chronic post-dural puncture headache do not have typical imaging features of intracranial hypotension: An MRI study using the Bern score. Headache. 2026 Jan;66(1):193-201. DOI: https://doi.org/10.1111/head.15057

Efficacy of Traditional Epidural Patching versus Patching within Spinal Longitudinal Extradural Collections for Ventral Dural Cerebrospinal Fluid Leaks

Callen AL, Pisani Petrucci SL, Lennarson P, Sedrak MF, Gutierrez A, Mamlouk MD. Efficacy of Traditional Epidural Patching versus Patching within Spinal Longitudinal Extradural Collections for Ventral Dural Cerebrospinal Fluid Leaks. Radiology. 2025 Mar;314(3):e242194. DOI: https://doi.org/10.1148/radiol.242194

Early brain MRI changes following transvenous embolization of cerebrospinal fluid-venous fistulas in spontaneous intracranial hypotension

Cagnazzo F, Le Bars E, Risi G, Lonjon N, van Dokkum LEH, Corti L, Costalat V, Ducros A. Early brain MRI changes following transvenous embolization of cerebrospinal fluid-venous fistulas in spontaneous intracranial hypotension. J Neurointerv Surg. 2026 Jan 13;18(2):442-449. DOI: 10.1136/jnis-2024-022957

CT-Guided Epidural Contrast Injection for the Identification of Dural Defects

Mark IT, Oien M, Benson JC, Verdoorn J, Johnson-Tesch B, Kim DK, Cutsforth-Gregory J, Madhavan AA. CT-Guided Epidural Contrast Injection for the Identification of Dural Defects. AJNR Am J Neuroradiol. 2025 Jan 8;46(1):207-210. DOI: https://doi.org/10.3174/ajnr.A8437

Spine MRI Diverticular Patterns Predict CSF-Venous Fistula Location: A 100-Patient Study

Mamlouk MD, Latoff JFR, Gutierrez A, Sedrak MF. Spine MRI Diverticular Patterns Predict CSF-Venous Fistula Location: A 100-Patient Study. AJNR Am J Neuroradiol. 2025 Oct 10:ajnr.A9042. DOI: https://doi.org/10.3174/ajnr.A9042

Continuum: disorders of CSF Dynamics

Disorders of CSF Dynamics. June 2025. Volume 31. Issue 3. Jeremy K. Cutsforth-Gregory, MD, FAAN, Guest Editor. https://continuum.aan.com/toc/con/31/3

The impact of CSF venous fistula embolization on patient’s quality of life, a longitudinal clinical-radiological exploration

Goapper M, van Dokkum LEH, Costalat V, Risi G, Corti L, Portalier O, Lonjon N, Le Bars E, Ducros A, Cagnazzo F. The impact of CSF venous fistula embolization on patient's quality of life, a longitudinal clinical-radiological exploration. J Headache Pain. 2025 May 19;26(1):120. DOI: https://doi.org/10.1186/s10194-025-02056-6

Patterns of Epidural Patch Distribution: The Influence of Spinal Level, Injection Technique, and Patch Volume/Composition on Craniocaudal and Ventral Epidural Dispersion

Montes D, Pisani Petrucci SL, Bhaumik D, Andonov N, Lennarson P, Callen AL. Patterns of Epidural Patch Distribution: The Influence of Spinal Level, Injection Technique, and Patch Volume/Composition on Craniocaudal and Ventral Epidural Dispersion. AJNR Am J Neuroradiol. 2025 Sep 2;46(9):1931-1938. DOI: https://doi.org/10.3174/ajnr.A8720

The Overlooked Diagnosis of Spontaneous Intracranial Hypotension: Insights into Cerebrospinal Fluid Leak Anatomy

Rovira À, Torres-Ferrús M. The Overlooked Diagnosis of Spontaneous Intracranial Hypotension: Insights into Cerebrospinal Fluid Leak Anatomy. Radiology. 2025 Feb;314(2):e243926. DOI: https://doi.org/10.1148/radiol.243926

Defining the typical characteristics of orthostatic headache in patients with spontaneous intracranial hypotension

Mehta D, Cheema S, Glover S, et al. Defining the typical characteristics of orthostatic headache in patients with spontaneous intracranial hypotension. Cephalalgia. 2025;45(1). DOI: 10.1177/03331024241308154

2024

Collaborative Excellence: The Multi-Society Post-Dural Puncture Headache Guidelines

Uppal, V. Collaborative excellence: the multi-society post-dural puncture headache guidelines. ASRA Pain Medicine News 2024;49. DOI: https://doi.org/10.52211/asra110124.007.

“Flow void sign”: flow artefact on T2-weighted MRI can be an indicator of dural defect location in ventral type 1 spinal CSF leaks

Carlton Jones L, Edelmuth DGL, Butteriss D, Scoffings DJ. "Flow Void Sign": Flow Artifact on T2-Weighted MRI Can Be an Indicator of Dural Defect Location in Ventral Type 1 Spinal CSF Leaks. AJNR Am J Neuroradiol. 2025 Jan 8;46(1):211-218.

DOI: https://doi.org/10.3174/ajnr.A8445

Hypermobile Ehlers-Danlos syndrome and spontaneous CSF leaks: the connective tissue conundrum

Severance S, Daylor V, Petrucci T, Gensemer C, Patel S, Norris RA. Hypermobile Ehlers-Danlos syndrome and spontaneous CSF leaks: the connective tissue conundrum. Front Neurol. 2024 Jul 17;15:1452409. DOI: https://doi.org/10.3389/fneur.2024.1452409

Spontaneous intracranial hypotension – a spinal disease

Zander C, Wolf K, El Rahal A, Volz F, Beck J, Urbach H, Lützen N. Spontaneous intracranial hypotension - a spinal disease. Rofo. 2025 Jan;197(1):44-54. English, German. DOI: 10.1055/a-2318-8994

Spinal Cerebrospinal Fluid Leak Localization with Digital Subtraction Myelography: Tips, Tricks, and Pitfalls

Galvan J, Maya M, Prasad RS, Wadhwa VS, Schievink W. Spinal Cerebrospinal Fluid Leak Localization with Digital Subtraction Myelography: Tips, Tricks, and Pitfalls. Radiol Clin North Am. 2024 Mar;62(2):321-332. DOI: https://doi.org/10.1016/j.rcl.2023.10.004

Fistula espontánea de LCR como manifestación de la hipertensión intracraneal idiopática

Samsara López Hernández, Carlos Alberto Rodríguez Arias, Jaime Santos Pérez , Mario Martínez-Galdámez , Adrián Fernández García , Herbert Daniel Jiménez Zapata. Fistula espontánea de LCR como manifestación de la hipertensión intracraneal idiopática. Neurocirugía. Volume 35, Issue 2, March–April 2024, Pages 57-63

DOI: https://doi.org/10.1016/j.neucir.2023.02.001

Diagnosis and Treatment of Spontaneous Intracranial Hypotension. Role of Epidural Blood Patching

Callen AL, Friedman DI, Parikh S, Rau JC, Schievink WI, Cutsforth-Gregory JK, Amrhein TJ, Haight E, Cowan RP, Barad MJ, Hah JM, Jackson T, Deline C, Buchanan AJ, Carroll I. Diagnosis and Treatment of Spontaneous Intracranial Hypotension: Role of Epidural Blood Patching. Neurol Clin Pract. 2024 Jun;14(3):e200290. DOI: https://doi.org/10.1212/CPJ.000000000020029

Beyond myths: Transformative insights into spinal cerebrospinal fluid leaks and their role in persistent headache syndromes

Carroll I, Callen AL. Beyond myths: Transformative insights into spinal cerebrospinal fluid leaks and their role in persistent headache syndromes. Headache. 2024 Mar;64(3):229-232. DOI: https://doi.org/10.1111/head.14677

Beyond myths: Transformative insights into spinal cerebrospinal fluid leaks and their role in persistent headache syndromes

Mechanism of chronic iatrogenic CSF leak following dural puncture-ventral dural leak: case report

Carroll IR, Lansinger O, Do HM, Dodd R, Mahaney K, Li D. Mechanism of chronic iatrogenic CSF leak following dural puncture-ventral dural leak: case report. Reg Anesth Pain Med. 2024 Apr 2;49(4):293-297. DOI: https://doi.org/10.1136/rapm-2023-105197

Patterns of clinical and imaging presentations in patients with spontaneous intracranial hypotension due to spinal cerebrospinal fluid venous fistula: A single-center retrospective cross-sectional study

Callen AL, Han L, Pisani Petrucci SL, Andonov N, Lennarson P, Birlea M, O'Brien C, Wilhour D, Anderson A, Bennett JL, Carroll IR. Patterns of clinical and imaging presentations in patients with spontaneous intracranial hypotension due to spinal cerebrospinal fluid venous fistula: A single-center retrospective cross-sectional study. Headache. 2024 Sep;64(8):939-949. DOI: https://doi.org/10.1111/head.14805

Spontaneous intracranial hypotension – a spinal disease

Zander C, Wolf K, El Rahal A, Volz F, Beck J, Urbach H, Lützen N. Spontaneous intracranial hypotension - a spinal disease. Rofo. 2025 Jan;197(1):44-54. English, German. DOI: 10.1055/a-2318-8994

Expounding on the Distinction between Lateral Dural Tears and Leaking Meningeal Diverticula in Spontaneous Intracranial Hypotension

Madhavan AA, Farb RI, Brinjikji W, Cutsforth-Gregory JK, Schievink WI. Expounding on the Distinction between Lateral Dural Tears and Leaking Meningeal Diverticula in Spontaneous Intracranial Hypotension. AJNR Am J Neuroradiol. 2024 Aug 9;45(8):E28-E29. DOI: https://doi.org/10.3174/ajnr.A8308

Brain MRI features of postdural puncture headache

Sánchez García FJ, Jornet Fayos J, Pastor Del Campo A, LLopis Calatayud JE. Brain MRI features of postdural puncture headache. Reg Anesth Pain Med. 2025 Apr 10;50(4):352-357. DOI: https://doi.org/10.1136/rapm-2023-105105

Diagnostic Yield of Decubitus CT Myelography for Detection of CSF-Venous Fistulas

Gibby JT, Amrhein TJ, Young DS, Houk JL, Kranz PG. Diagnostic Yield of Decubitus CT Myelography for Detection of CSF-Venous Fistulas. AJNR Am J Neuroradiol. 2024 Oct 3;45(10):1597-1604. DOI: https://doi.org/10.3174/ajnr.A8330

Impact of Spinal CSF Leaks on Quality of Life and Mental Health and Long-Term Reversal by Surgical Closure

Volz F, Wolf K, Fung C, Carroll I, Lahmann C, Lützen N, Urbach H, Klingler JH, Beck J, El Rahal A. Impact of Spinal CSF Leaks on Quality of Life and Mental Health and Long-Term Reversal by Surgical Closure. Neurol Clin Pract. 2024 Apr;14(2):e200272. DOI: https://doi.org/10.1212/CPJ.0000000000200272

Optic Nerve Sheath MR Imaging Measurements in Patients with Orthostatic Headaches and Normal Findings on Conventional Imaging Predict the Presence of an Underlying CSF-Venous Fistula

Schievink WI, Maya MM, Tay ASS, Nisson PL, Acharya J, Taché RB, Nuño M. Optic Nerve Sheath MR Imaging Measurements in Patients with Orthostatic Headaches and Normal Findings on Conventional Imaging Predict the Presence of an Underlying CSF-Venous Fistula. AJNR Am J Neuroradiol. 2024 May 9;45(5):655-661. DOI: https://doi.org/10.3174/ajnr.A8165

2023

Utility of Photon-Counting Detector CT Myelography for the Detection of CSF-Venous Fistulas

Madhavan AA, Yu L, Brinjikji W, Cutsforth-Gregory JK, Schwartz FR, Mark IT, Benson JC, Amrhein TJ. Utility of Photon-Counting Detector CT Myelography for the Detection of CSF-Venous Fistulas. AJNR Am J Neuroradiol. 2023 Jun;44(6):740-744. DOI: https://doi.org/10.3174/ajnr.A7887

Finding the Leak: Tips for CSF Leak and Venous Fistula Localization

https://arrsinpractice.org/finding-the-leak-tips-for-csf-leak-and-venous-fistula-localization/

Quality of Life in Patients With Confirmed and Suspected Spinal CSF Leaks

Liaw V, McCreary M, Friedman DI. Quality of Life in Patients With Confirmed and Suspected Spinal CSF Leaks. Neurology. 2023 Dec 4;101(23):e2411-e2422. DOI:

https://doi.org/10.1212/WNL.0000000000207763

Resisted Inspiration Improves Visualization of CSF-Venous Fistulas in Spontaneous Intracranial Hypotension

Kranz PG, Malinzak MD, Gray L, Willhite J, Amrhein TJ. Resisted Inspiration Improves Visualization of CSF-Venous Fistulas in Spontaneous Intracranial Hypotension. AJNR Am J Neuroradiol. 2023 Aug;44(8):994-998. DOI: https://doi.org/10.3174/ajnr.A7927

Keyhole Fenestration for Cerebrospinal Fluid Leaks in the Thoracic Spine: Quantification of Bone Removal and Microsurgical Anatomy

Volz F, Doria-Medina R, Fung C, Wolf K, El Rahal A, Lützen N, Urbach H, Loidl TB, Hubbe U, Klingler JH, Beck J. Keyhole Fenestration for Cerebrospinal Fluid Leaks in the Thoracic Spine: Quantification of Bone Removal and Microsurgical Anatomy. Oper Neurosurg. 2024 Jul 1;27(1):1-9. DOI:10.1227/ons.0000000000001042

Temporal Characteristics of CSF Venous Fistulas on Dynamic Decubitus CT Myelography: A Retrospective Multi-Institution Cohort Study

Callen AL, Fakhri M, Timpone VM, Thaker AA, Dillon WP, Shah VN. Temporal Characteristics of CSF-Venous Fistulas on Dynamic Decubitus CT Myelography: A Retrospective Multi-Institution Cohort Study. AJNR Am J Neuroradiol. 2023 Dec 29;45(1):100-104. DOI: https://doi.org/10.3174/ajnr.A8078

Validity of the Bern Score as a Surrogate Marker of Clinical Severity in Patients with Spontaneous Intracranial Hypotension

Houk JL, Morrison S, Peskoe S, Amrhein TJ, Kranz PG. Validity of the Bern Score as a Surrogate Marker of Clinical Severity in Patients with Spontaneous Intracranial Hypotension. AJNR Am J Neuroradiol. 2023 Sep;44(9):1096-1100. DOI:

https://doi.org/10.3174/ajnr.A7962