EDITOR'S CHOICESpine Imaging and Spine Image-Guided Interventions
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Assessing the Diagnostic Value of Brain White Matter Hyperintensities and Clinical Symptoms in Predicting the Detection of CSF-Venous Fistula in Patients with Suspected Spontaneous Intracranial Hypotension
Samantha L. Pisani Petrucci, Nadya Andonov, Peter Lennarson, Marius Birlea, Chantal O’Brien, Danielle Wilhour, Abigail Anderson, Jeffrey L. Bennett and Andrew L. Callen
American Journal of Neuroradiology May 2025, 46 (5) 1036-1043; DOI: https://doi.org/10.3174/ajnr.A8548
The purpose of this retrospective cohort study was to assess the quantity and distribution pattern of WMH in patients with suspected SIH who underwent subsequent dynamic CTM. Patients with CVF had significantly higher Bern scores and significantly fewer WMH than those without CVF. Also, the migraine-type pattern of WMH was present at a nearly 4-fold greater frequency in the CVF- group versus the CVF+ group. Additionally, the symptom data demonstrated distinct clinical phenotypes between patients with CVF (eg, higher occurrence of a pressure-type or throbbing headache, symptoms worsening with the Valsalva maneuver) and those without CVF (eg, neck pain, fatigue, photophobia, and phonophobia).
