Headache and Pain Research

Original Article

Availability, Accessibility, and Utilization of Diagnostics and Therapeutics for Spontaneous Intracranial Hypotension in Asia: Soyoun Choi, Woo-Seok Ha, Soo-Jin Cho, Aynur Özge, Betül Baykan, Esme Ekizoglu, Kiratikorn Vongvaivanich, Koichi Hirata, Linh Tuyen Nguyen, Mamoru Shibata, Min Kyung Chu, Otgonbayar Luvsannorov, Ryotaro Ishii, Shengyuan Yu, Shih-Pin Chen, Shuu-Jiun Wang, Takao Takeshima, Tsubasa Takizawa, Vinh Khang Nguyen, Wei-Ta Chen, Yen-Feng Wang, Soo-Kyoung Kim, Mi Ji Lee; Headache Pain Res. 2025;26(2):142-153. Published online June 16, 2025; DOI: https://doi.org/10.62087/hpr.2025.0005

3,622 View
38 Download
2 Citations

Purpose: Recent advances in imaging techniques have significantly enhanced the diagnosis of spontaneous intracranial hypotension (SIH). However, these developments have been reported mostly in Europe and the United States. This study aimed to evaluate the availability and utilization of diagnostic and treatment modalities for SIH in Asia, through a survey of regional headache specialists.
Methods
A literature search was conducted using PubMed, and members of the Asian Regional Consortium for Headache were contacted. Participants completed a two-step survey evaluating the availability, accessibility, and frequency of SIH diagnostic and treatment methods in their countries and institutions. Descriptive statistics were used to analyze the data.
Results
Twenty physicians from eight countries completed both rounds of the survey. Lumbar puncture, brain magnetic resonance imaging (MRI), and spinal MRI are widely available across Asia, but real-time imaging techniques—such as dynamic computed tomography myelography and digital subtraction myelography—that precisely localize cerebrospinal fluid leaks are less accessible. Blind or semi-targeted epidural blood patches (EBPs) are available at most centers, but are easily accessible in only about half of cases. Surgical interventions are rarely available.
Conclusion
Most diagnostic methods for SIH are available in Asia, despite some regional disparities. The utilization of EBP and surgical interventions remains somewhat limited. This highlights the need for greater awareness and standardization of diagnostic methods in Asia.

Citations

Citations to this article as recorded by

Temporal and regional trends in the diagnosis and treatment of spontaneous intracranial hypotension: a systematic review
Woo-Seok Ha, Soyoun Choi, Mi-Kyoung Kang, Hye Yun Kim, Soo-Jin Cho, Soo-Kyoung Kim, Mi Ji Lee
The Journal of Headache and Pain.2026;[Epub] CrossRef
Diagnostic Value of Flow-Void Sign for Localizing Ventral Dural Defects in Spine MRI
Soo-Im Jang, Soyoun Choi, Seung Ae Kim, Hoe Jong Jeong, Ja-Young Choi, Mi Ji Lee
Journal of Clinical Neurology.2026;[Epub] CrossRef

Case Report

Spontaneous Intracranial Hypotension after Airplane Travel: Ho Jin Hwang, Jiyun Park, Sun Jae Moon, Dong Hyun Hwang, Kyongha Baek, Young Seo Kim; Korean J Headache. 2023;24(2):77-79. Published online December 31, 2023

1,241 View
23 Download

Abstract PDF: Spontaneous intracranial hypotension usually manifests orthostatic headache caused by cerebrospinal fluid leakage without procedure or trauma to meninges. There was temporal relationship between intracranial hypotension and various precipitating factors such as positional changes, valsalva maneuver, minor trauma and only rarely airplane travel. Here, we report the first korean case of spontaneous intracranial hypotension after airplane travel. A 37-year-old woman presented with orthostatic headache after airplane travel. Her cerebrospinal fluid pressure is 55 mmCSF and cervical spinal level of cerebrospinal fluid leakage confirmed by cisternography. Her symptoms resolved after the epidural blood patch and she was later discharged without any complications.

First
Prev
Page of 1
Next
Last

Search