Spontaneous Intracranial Hypotension (SIH) is a condition characterized by a decrease in the pressure of the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord, occurring without any significant trauma or medical intervention. This low pressure typically results from fluid leaking through a spontaneous small tear or hole in the membrane surrounding the spinal canal (the dura mater). The reduction in CSF volume causes the brain to lose its "cushioning" support within the skull, leading the brain to sag downward and exert pressure on pain-sensitive structures.
The most typical and diagnostic symptom of the condition is an "orthostatic headache." This pain begins severely shortly after a person stands up or sits down but disappears completely or significantly subsides when lying down. The headache is frequently accompanied by symptoms such as neck pain, nausea, sensitivity to light and sound, ringing in the ears (tinnitus), or hearing changes. Contrast-enhanced brain and spinal MRI imaging are primarily used in the diagnostic process; characteristic signs such as enhancement of the meninges and brain displacement are sought in the MRI findings.
The first step in the treatment of SIH usually involves conservative (non-surgical) methods such as bed rest, high fluid intake, and caffeine consumption. In cases where these methods are insufficient or the leak persists, a procedure called an "Epidural Blood Patch" is performed. In this procedure, the patient's own blood is injected into the leakage site in the spinal canal to act as a plug, allowing the tear to close on its own. In rarer and more persistent cases, microsurgical methods are utilized to directly close the site of the leak. Early diagnosis is critical for rapidly restoring the patient's quality of life.
Spontaneous Intracranial Hypotension Spontaneous Intracranial Hypotension (SIH) is a condition characterized by a decrease in the pressure of the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord, occurring without any significant trauma or medical intervention. This low pressure typically results from fluid leaking through a spontaneous small tear or hole in the membrane […]
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Piriformis syndrome is a neuromuscular condition that occurs when the piriformis muscle, located deep within the hip region, compresses or irritates the sciatic nerve passing nearby. While this muscle performs a critical function by enabling the external rotation of the leg, it exerts pressure on the sciatic nerve—the longest nerve in the body—in cases of […]
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Basic Anatomy of The Spine and Spinal Cord The spine consists of 33 vertebrae. Seven of these bones are cervical vertebrae, 12 are thoracic vertebrae, and 5 are lumbar vertebrae. Five of them are fused to form the sacrum, and 4 are fused to form the coccyx, also known as the tailbone. The function of […]
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Disc Herniation Herniated discs in the neck (cervical), back (lumbar), or more rarely in the mid-back (thoracic) are illness caused by degeneration of structures called discs located between the spinal bones, due to various reasons such as trauma, heavy lifting, excess weight, aging, poor posture, and genetic predisposition. Following the degeneration of the annulus of […]
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Spondylolisthesis (Spinal Slippage) Spondylolisthesis, or spinal displacement (spinal slippage), is the displacement of one or more vertebrae in the spine that are normally aligned, due to various reasons. This displacement can occur forwards, backwards, to the right, or to the left, affecting the neck, back, or lower back. It can occur in a single vertebra […]
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Spinal Stenosis (Narrowing of The Spinal Canal) Spinal stenosis, commonly known as "narrow canal," is a condition characterized by the narrowing of the spinal canal for various reasons, leading to pressure on the spinal cord and the nerves passing through it. This narrowing can occur at any level of the spine, including the neck (cervical), […]
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Spinal Tumors Spinal tumors are abnormal masses of cells that develop within the spinal canal or the bony structures (vertebrae) that form the spine. These tumors may originate directly from the spine's own tissues (primary tumors) or can occur when cancer from another part of the body—such as the lungs, breasts, or prostate—spreads to the […]
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Spinal Cord Tumors Spinal cord tumors are abnormal masses of cells that develop from the cells forming the spinal cord tissue or its surrounding structures. They are primarily categorized into two main groups based on their anatomical location and the area of development. This classification is critical for determining both the surgical approach and the […]
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Carpal Tunnel Syndrome Carpal tunnel syndrome is a condition that occurs when the median nerve, one of the major nerves in the hand, is compressed and subjected to pressure within a structure called the carpal tunnel at the wrist level, due to various reasons. Causes include repetitive hand and wrist movements (computer use, playing musical […]
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Cubital Tunnel Syndrome Cubital tunnel syndrome is a condition that occurs when the ulnar nerve, one of the three main nerves in the hand, becomes compressed or exposed to pressure at the elbow region. The nerve travels between two bony protrusions on the inner side of our elbow and passes through a structure called the […]
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Peroneal neuropathy is a condition involving damage to or compression of the peroneal nerve (fibular nerve), which provides motor and sensory control to the lower leg and the top surface of the foot. A branch of the sciatic nerve, the peroneal nerve follows a course very close to the surface at the level of the […]
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Thoracic outlet syndrome (TOS) is a complex condition that occurs as a result of the compression of nerves or blood vessels passing through the narrow space between the clavicle (collarbone) and the first rib, known as the thoracic outlet. This narrowing typically results from traumatic injuries, repetitive arm and shoulder movements, postural disorders, or anatomical […]
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Basic Anatomy of Central Nervous System The nervous system is generally divided into the central nervous system and the peripheral nervous system. The central nervous system consists of the brain, brainstem, cerebellum, and spinal cord. The peripheral nervous system consists of spinal nerves originating from the spinal cord and the autonomic nervous system. MENINGES (BRAIN […]
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Brain Tumors The causes of brain tumors are not fully understood, but risk factors include radiation exposure, genetic disorders, a family history of tumors, diseases that affect the immune system, stress, and exposure to various environmental carcinogens. It is thought that brain tumors occur as a result of damage or improper function of specific genes […]
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Pituitary Tumor The pituitary gland is a vital endocrine gland located at the base of the brain in a small bony cavity called the "sella turcica" (Turkish saddle) and is widely known as the body's "conductor of the orchestra." Pituitary tumors are masses that arise from the abnormal and uncontrolled growth of cells within this […]
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Head Injuries Head traumas are injuries resulting from blows to the head, falls, traffic accidents, or sports injuries, covering a wide spectrum from simple scalp lacerations to life-threatening brain damage. These traumas can manifest as skull fractures, concussions, brain tissue contusions, or intracranial hemorrhages. Regardless of the intensity of the impact, every head trauma carries […]
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Chiari malformation (commonly known as Chiari syndrome) is a structural disorder characterized by the protrusion (herniation) of cerebellar tissue through the opening at the base of the skull (foramen magnum) into the spinal canal. Under normal conditions, the parts of the cerebellum should be located entirely within the skull; however, they are pushed downward due […]
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Parkinson's Disease and Deep Brain Stimulation (DBS) Parkinson's disease is a progressive and chronic neurodegenerative disorder that occurs as a result of the loss of dopamine-producing cells responsible for controlling movements in the brain. Although it is usually seen in individuals over the age of 60, it can also manifest at younger ages due to […]
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