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Spontaneous cerebrospinal fluid leakage causes orthostatic headache, and mental dullness, diplopia, and coma may occur. Most cases are due to a tear in the spinal CSF membranes. MRI shows enhancement of the dura, and special imaging, such as digital-subtraction myelography (shown in videos), may be required to show the leakage site.
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From the Department of Neurosurgery, Cedars–Sinai Medical Center, Los Angeles.
Dr. Schievink can be contacted at [email protected] or at the Department of Neurosurgery, Cedars–Sinai Medical Center, 127 S. San Vicente Blvd., Ste. A6600, Los Angeles, CA 90048.
December 2, 2021
N Engl J Med 2021; 385:2173-2178
DOI: 10.1056/NEJMra2101561
Allan H. Ropper, M.D., Editor
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