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Frequency and Diagnostic Utility of Clinical and Radiological Features of Spontaneous Intracranial Hypotension in Postpartum Patients with Neurological Symptoms: A Cross-Sectional Study | ||
| Iranian Journal of Medical Sciences | ||
| مقاله 3، دوره 51، شماره 4، تیر 2026، صفحه 248-255 اصل مقاله (595.96 K) | ||
| نوع مقاله: Original Article(s) | ||
| شناسه دیجیتال (DOI): 10.30476/ijms.2025.108257.4312 | ||
| نویسندگان | ||
| Farrokh Seilanian Toosi1؛ Armin Doostparast2، 3؛ Maryam Emadzadeh4؛ Nafiseh Akbari* 1 | ||
| 1Department of Radiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran | ||
| 2Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran | ||
| 3Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran | ||
| 4Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran | ||
| چکیده | ||
| Background: Spontaneous intracranial hypotension (SIH) is an often underrecognized neurological condition resulting from spontaneous cerebrospinal fluid (CSF) leaks. Postpartum women represent a vulnerable population due to unique physiological and procedural factors, yet SIH remains poorly characterized in this group. This study aimed to determine the diagnostic value of clinical and radiological features in identifying SIH among postpartum patients with neurological symptoms. Methods: In a retrospective observational study conducted at Qaem Hospital (Mashhad, Iran), 183 postpartum patients presenting with central nervous system (CNS) symptoms who underwent brain magnetic resonance imaging (MRI) between 2010 and 2023 were evaluated. Demographic, clinical, and gynecologic data were collected. Brain MRI findings were independently reviewed for features indicative of SIH. Comparative analyses were conducted between patients with and without SIH using Fisher’s exact test. Results: SIH was identified in 30 patients (16.4%), making it the third most common diagnosis after normal MRI (46.5%) and posterior reversible encephalopathy syndrome (30.4%). Orthostatic headache (63.3%) and seizure (43.3%) were the most common symptoms among SIH patients. However, no clinical symptom significantly differentiated SIH from non-SIH cases (P>0.05). Specific MRI findings—particularly pachymeningeal enhancement (P<0.001), dural venous sinus distension (P<0.001), pituitary enlargement (P=0.01), and brain sagging (P=0.004)—were significantly more frequent in SIH patients. Conclusion: SIH is a noteworthy cause of postpartum neurological symptoms. Given the limited specificity of clinical features, contrast-enhanced brain MRI plays a crucial role in diagnosis. Clinicians should maintain a high index of suspicion for SIH in postpartum patients presenting with CNS symptoms. | ||
تازه های تحقیق | ||
Farrokh Seilanian Toosi (Google Scholar) | ||
| کلیدواژهها | ||
| Intracranial hypotension؛ Postpartum period؛ Magnetic resonance imaging؛ Neurological manifestations؛ Cerebrospinal fluid leak | ||
| مراجع | ||
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آمار تعداد مشاهده مقاله: 21 تعداد دریافت فایل اصل مقاله: 16 |
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