What are common symptoms and test findings in spontaneous intracranial hypotension
The headache can be associated with neck stiffness or pain, nausea ± vomiting, light and noise sensitivity, muffled hearing, tinnitus, interscapular pain, upper extremity radicular symptoms, sense of imbalance, and subtle cognitive dysfunction.
Less commonly, patients report visual changes (blurring, visual field defects, diplopia), facial pain or numbness, facial weakness, and dysgeusia.
The MRI of the brain is abnormal in 80% of cases. The most common abnormality is diffuse pachymeningeal (dura and outer layer of the arachnoid mater) enhancement.
The opening pressure on lumbar puncture will often be low, less than 60 mm of H 2 O, but normal pressures are common.
CSF may be clear or xanthochromic, with either normal or elevated protein (as high as 1000 mg/dL), normal glucose, and either a normal leukocyte count or a lymphocytic pleocytosis (as high as 222 cells/mm 2 ).
The patient may also have an elevated erythrocyte count.
