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KMID : 0911820220230010009
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Korean Journal of Headache
2022 Volume.23 No. 1 p.9 ~ p.14
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Diagnostic Delay in Spontaneous Intracranial Hypotension
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Kim Ji-Young
Park Youn-Jin
Sohn Jong-Hee
Lee Sang-Hwa
Khil Eun-Kyung
Im Hee-Jin
Song Min-Jun
Cha Myoung-Jin
Cho Soo-Jin
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Abstract
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Background: Spontaneous intracranial hypotension (SIH) develops a headache caused by cerebrospinal fluid (CSF)
leakage without known cause of procedure or trauma to meninges. The purpose of this study was to investigate
the time interval from symptom onset to diagnosis and the relevant factors of diagnostic delay in patients with SIH.
Methods: We analyzed the medical records of three hospitals patients diagnosed with SIH between January
2011 and January 2022. We collected information on the demographics, interval from symptom onset to diagnosis, and clinical features. Subjects with an interval from symptom onset to diagnosis in the third or higher
quartiles among patients with SIH were defined as the delayed diagnosis group.
Results: This study included 131 patients with SIH. The mean interval from symptom onset to diagnosis was
20.1±37.8 days (interquartile range: 3.0-21.0). One hundred and seventeen patients (89.3%) had orthostatic headache.
Without orthostatic headache (odds ratio=5.43, 95% confidence interval=1.40-21.08) in clinical symptoms was
an increased risk of delayed diagnosis of SIH.
Conclusion: In this study, about one-tenth of SIH patients did not present orthostatic headache. Without orthostatic headache was an associated factor of delayed diagnosis in SIH.
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KEYWORD
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Spontaneous intracranial hypotension, Orthostatic headache, Cerebrospinal fluid
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