The decision to use noncontrast (eg, time-of-flight or phase-contrast) versus contrast techniques may depend on the preferences of different institutions. The use of IV contrast helps clearly delineate the venous sinus lumen and avoids some of the flow- related artifacts encountered in noncontrast MRV techniques, which can be more prone to misinterpretation [36,38]. Headache Therefore, noncontrast brain MRV should be interpreted with attention to possible artifacts related to slow or turbulent flow and in conjunction with brain MRI, if previously performed. MRV Head Without IV Contrast Venous outflow obstruction either by an intraluminal thrombus or an extrinsic stenosis has been shown to be associated with elevated intracranial pressure and IIH; therefore, venous imaging such as brain MRV can be useful in the imaging evaluation of headache with features of intracranial hypertension. The decision to use noncontrast (eg, time-of-flight or phase-contrast) versus contrast techniques may depend on the preferences of different institutions. The use of IV contrast helps clearly delineate the venous sinus lumen and avoids some of the flow- related artifacts encountered in noncontrast MRV techniques, which can be more prone to misinterpretation [36,38]. Therefore, noncontrast brain MRV should be interpreted with attention to possible artifacts related to slow or turbulent flow and in conjunction with brain MRI, if previously performed. Arteriography Cervicocerebral There is no relevant literature to support the use of cervicocerebral arteriography in the initial imaging evaluation of headache with features of intracranial hypotension. CT Head With IV Contrast There is no relevant literature to support the use of CT head with IV contrast in the initial imaging evaluation of headache with features of intracranial hypotension; although some findings of SIH can be detected on noncontrast head CT, contrast-enhanced brain MRI is needed to evaluate for pachymeningeal enhancement.
Headache PCAs. The decision to use noncontrast (eg, time-of-flight or phase-contrast) versus contrast techniques may depend on the preferences of different institutions. The use of IV contrast helps clearly delineate the venous sinus lumen and avoids some of the flow- related artifacts encountered in noncontrast MRV techniques, which can be more prone to misinterpretation [36,38]. Headache Therefore, noncontrast brain MRV should be interpreted with attention to possible artifacts related to slow or turbulent flow and in conjunction with brain MRI, if previously performed. MRV Head Without IV Contrast Venous outflow obstruction either by an intraluminal thrombus or an extrinsic stenosis has been shown to be associated with elevated intracranial pressure and IIH; therefore, venous imaging such as brain MRV can be useful in the imaging evaluation of headache with features of intracranial hypertension. The decision to use noncontrast (eg, time-of-flight or phase-contrast) versus contrast techniques may depend on the preferences of different institutions. The use of IV contrast helps clearly delineate the venous sinus lumen and avoids some of the flow- related artifacts encountered in noncontrast MRV techniques, which can be more prone to misinterpretation [36,38]. Therefore, noncontrast brain MRV should be interpreted with attention to possible artifacts related to slow or turbulent flow and in conjunction with brain MRI, if previously performed. Arteriography Cervicocerebral There is no relevant literature to support the use of cervicocerebral arteriography in the initial imaging evaluation of headache with features of intracranial hypotension. CT Head With IV Contrast There is no relevant literature to support the use of CT head with IV contrast in the initial imaging evaluation of headache with features of intracranial hypotension; although some findings of SIH can be detected on noncontrast head CT, contrast-enhanced brain MRI is needed to evaluate for pachymeningeal enhancement.