Spontaneous intracranial hypotension with negative brain MRI findings: a systematic review of diagnostic strategies and clinical outcomes - Takeaways - MDSpire

Spontaneous intracranial hypotension with negative brain MRI findings: a systematic review of diagnostic strategies and clinical outcomes

  • By

  • Marina Romozzi

  • Giuseppe Garignano

  • Valid Rastegar

  • Francesco Onorati

  • Catello Vollono

  • Federico Tosto

  • Masahito Katsuki

  • Yasuhiko Matsumori

  • Francesco Signorelli

  • July 9, 2026

  • 0 min

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  • 1

    Spontaneous intracranial hypotension (SIH) can occur with normal brain MRI findings, complicating diagnosis despite typical clinical symptoms.

  • 2

    Advanced imaging techniques like CT myelography and digital subtraction myelography are crucial for identifying occult cerebrospinal fluid leaks.

  • 3

    Patients with MRI-negative SIH often experience longer symptom duration and higher recurrence rates compared to those with typical MRI findings.

  • 4

    Epidural blood patch treatment may benefit selected patients, while surgical repair of leaks can lead to significant clinical improvement.

  • 5

    The absence of typical brain MRI findings should not exclude SIH diagnosis; further evaluation is necessary for accurate patient outcomes.

Original Source(s)

Spontaneous intracranial hypotension with negative brain MRI findings: a systematic review of diagnostic strategies and clinical outcomes

  • by Marina Romozzi, Giuseppe Garignano, Valid Rastegar, Francesco Onorati, Catello Vollono, Federico Tosto, Masahito Katsuki, Yasuhiko Matsumori, Francesco Signorelli

  • July 9, 2026

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