TY - JOUR
T1 - Headache and Dural Enhancement
T2 - Two Case Studies of Different Treatable Pathologies
AU - Pensato, Umberto
AU - Benini, Matteo
AU - Fabbri, Viscardo Paolo
AU - Avoni, Patrizia
AU - Foschini, Maria Pia
AU - Rizzo, Giovanni
AU - Liguori, Rocco
N1 - Ricercatore distaccato presso IRCCS a seguito Convenzione esclusiva con Università di Bologna (Avoni Patrizia, Rizzo Giovanni, Liguori Rocco)
PY - 2020/9
Y1 - 2020/9
N2 - Background: Hypertrophic pachymeningitis (HP) and spontaneous intracranial hypotension are different treatable diseases, which should promptly be recognized and treated to prevent neurologic sequelae. Headache and dural enhancement are the main features of both diseases, thus differentiating between these 2 conditions can be difficult. Cases Description: We present 2 cases with headache and dural enhancement, in which the differential diagnosis was challenging at presentation because, in both cases, clear positional pain modification was not reported. Each patient was referred to us with the suspicion of a diagnosis actually affecting the other one. Based on further findings, which supported diagnosis of spontaneous intracranial hypotension in the first case and of HP in the second one, we briefly review clinical, radiologic, and laboratory features, which can help in the differential diagnosis. Conclusions: An accurate diagnostic workup is mandatory to distinguish among HP and intracranial hypotension.
AB - Background: Hypertrophic pachymeningitis (HP) and spontaneous intracranial hypotension are different treatable diseases, which should promptly be recognized and treated to prevent neurologic sequelae. Headache and dural enhancement are the main features of both diseases, thus differentiating between these 2 conditions can be difficult. Cases Description: We present 2 cases with headache and dural enhancement, in which the differential diagnosis was challenging at presentation because, in both cases, clear positional pain modification was not reported. Each patient was referred to us with the suspicion of a diagnosis actually affecting the other one. Based on further findings, which supported diagnosis of spontaneous intracranial hypotension in the first case and of HP in the second one, we briefly review clinical, radiologic, and laboratory features, which can help in the differential diagnosis. Conclusions: An accurate diagnostic workup is mandatory to distinguish among HP and intracranial hypotension.
KW - Cerebrospinal fluid leak
KW - Differential diagnosis
KW - Epidural blood patch
KW - Granulomatosis with polyangiitis
KW - Hypertrophic pachymeningitis
KW - Orthostatic headache
KW - Spontaneous intracranial hypotension
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U2 - 10.1016/j.wneu.2020.06.126
DO - 10.1016/j.wneu.2020.06.126
M3 - Article
C2 - 32593763
AN - SCOPUS:85087868190
VL - 141
SP - 306
EP - 310
JO - World Neurosurgery
JF - World Neurosurgery
SN - 1878-8750
ER -