Table 1.
Summary.
| Case | Age (Sex) | PMH | Orthostatic Headache (worse upright) | MRI | CTM | Intervention | Outcome: Headache improvement∗ |
|---|---|---|---|---|---|---|---|
| 1 | 25 (F) | Migraine | Yes | CTD | Multiple spinal level contrast spread at level C6-T1, T4-5, T7-8 level | Multi-level EBPs | Yes |
| 2 | 26 (F) | EDS, POTS | Yes | CTD | Multiple nerve root sleeves enhancement from C4 to T1, and T6 to L4 Opening pressure -4cm H20 |
Multi-level EBPs | Yes |
| 3 | 57 (F) | EDS, migraine | Yes | CTDa | Multiple nerve root sleeves enhancement from T7-S3 | Multi-level EBPs | Yes |
| 4 | 29 (M) | Alcohol Dependence | Yes | CTD | Multiple nerve root sleeves enhancement from T11-S1 | Multi-level EBPs | Yes |
| 5 | 41 (F) | POTS | Yes | CTDb | Negative∗∗ | Surgical repair | Yes |
PMH: Past Medical History MRI: Magnetic Resonance Imaging CTM: Computed Tomography Myelogram.
EDS: Ehler Danlos Syndrome POTS: Postural Orthostatic Tachycardia Syndrome CTD: Cerebellar tonsillar descent EBPs: Epidural blood patches.
∗
Duration, intensity, orthostatic features, concomitant symptoms at the 6-month follow up visit.
∗∗
Digital subtraction myelography – CSF venous fistula arising on the left at T4 and T5.
a
MRI also demonstrated reduced mamillopontine distance of 4.64 mm, abnormal pontomesencephalic angle less than 50°, convex pituitary with near complete effacement of the suprasellar cistern.
b
MRI also demonstrated TD, crowding of the posterior fossa, pituitary enlargement and effacement of the basilar cisterns.