• Doo-Sik Kong, Kwan Park, Do Hyun Nam, Jung-Il Lee, Jong Soo Kim, Whan Eoh, and Jong Hyun Kim.
• Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
• Neurosurgery. 2005 Jul 1; 57 (1): 91-6; discussion 91-6.

ObjectiveAlthough spontaneous intracranial hypotension (SIH) is an increasingly recognized syndrome, the long-term outcomes have not been established. We conducted a long-term follow-up study to clarify the clinical features and long-term outcomes of patients with this disorder.MethodsWe performed a retrospective study in 13 consecutive patients with SIH treated between 1998 and 2003. The diagnosis of intracranial hypotension was made on the basis of clinical symptoms, lumbar puncture, radiological studies (e.g. brain magnetic resonance imaging, spine magnetic resonance imaging, computed tomographic myelography) and radionuclide cisternography. We collected follow-up clinical information of the patients by telephone or by examination at an outpatient clinic.ResultsAll patients were treated by nonsurgical conservative treatments, such as absolute bed rest, intravenous hydration and repetitive epidural blood patch (5 patients). The mean duration of follow up was 51.4 months (range, 15-80 mo). Among 13 patients included in this study, only one patient (7.7%) developed recurrent SIH, and the other patients improved from orthostatic headache. Although 7 of 13 patients had complete resolution of headache at a minimum of 2 years follow-up, 4 patients had mild headache and 2 patients continued to have moderate headache at the final examination.ConclusionIn this series, the outcome of SIH after conservative treatment was not as satisfactory as that reported in previous studies. We conclude that periodic follow-up examinations must be performed and a more effective treatment modality developed to achieve complete resolution of SIH.

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