Abstract
This report describes a case with spinal dural enhancement on magnetic resonance imaging(MRI)assoiated with spontaneous intracranial hypotension(SIH).SIH is a condition characterized by postural headache, neck stiffness, and other symptoms. MRI of the head, CT-myelography, and RI-cisternography have been reported as useful diagnostic tools for SIH. Contrast-enhanced MRI of the head consistently reveals diffuse and uniform enhancement of the pachymeninges in patients with SIH. CT-myelography or RI-cisternography have been reported to not only manifest the extradural leakage of contrast medium or radioactive isotope, but also to reveal the causes of SHI(e.g.diverticulum, meningeal cysts). To data, there have been a few reports concerning the spinal MRI of SHI patients. Entire spinal dural enhancement in the patients with SIH has been reported. We describe a patient who presented with the characteristic radicular pain and postural headache associated with SIH. In the present case, MRI of the spine showed a patterm of spinal dural enhancement different from what have been previously reported ; dural enhancement of the cervical and upper thoracic cord was observed but none in the lower thoracic cord. This pattern of spinal dural enhancement may indicate the point of the CSF leak and the mechanism of spinal dural enhancement is briefly discussed.
