The symptoms included orthostatic headaches and other features that are now recognized as spontaneous intracranial hypotension. A few decades earlier, the same syndrome had been described in French literature as "hypotension of spinal fluid" and "ventricular collapse". In 1940, Henry Woltman of the Mayo Clinic wrote about "headaches associated with decreased intracranial pressure". The full clinical manifestations of intracranial hypotension and CSF leaks were described in several publications reported between the 1960s and early 1990s. Modern reports of spontaneous CSF leak have been reported to medical journals since the late 1980s. Research
Tetracosactide is a corticosteroid that causes the brain to produce additional spinal fluid to replace the volume of the lost CSF and alleviate symptoms, and has been given intravenously to treat CSF leaks.In three small studies of 1-2 patients with recurrent CSF leaks where repeated blood patches failed to form clots and relieve symptoms, the patients received temporary but complete resolution of symptoms with an epidural saline infusion. The saline infusion temporarily restores the volume necessary for a patient to avoid SIH until the leak can be repaired properly. Intrathecal saline infusion is used in urgent cases such as intractable pain or decreased consciousness.The gene TGFBR2 has been implicated in several connective tissue disorders including Marfan syndrome, arterial tortuosity, and thoracic aortic aneurysm. A study of patients with SCSFLS demonstrated no mutations in this gene. Minor features of Marfan syndrome have been found in 20% of CSF leak patients.
Other autoimmune diseases, such as systemic lupus erythematosus, can also cause myositis-like symptoms. Diagnosis
There are various tools that can be used to help diagnose myositis. The most common ones are: physical exam, electromyography, magnetic resonance imaging, muscle biopsy, and blood tests. The first thing your doctor will likely do is perform a physical exam. They will look for various things such as muscle weakness and rashes. Another possible test is an electromyography (EMG). This is a test that inserts tiny needles into your muscles. This allows a physician to look at your muscles’ response to various electrical nerve signals and evaluate which muscles potentially have myositis. Magnetic resonance imaging (MRI) is also useful. This is a test that uses a big magnet to create images on a computer. This allows a physician to examine your muscles. It is painless. Muscle biopsies are the most reliable tests for diagnosing myositis. It will tell your doctor for certain if you have myositis or not. There are also a variety of blood tests available that help in the diagnoses of myositis. Your doctor may look for elevation of creatine kinase in blood, which is indicative of muscle inflammation. Certain autoantibodies (antibodies that target your muscle cells) can also be found in the blood that can indicate that myositis is caused by an autoimmune disease. Some specific examples of autoantibodies are Anti-Jo-1, Anti-HMGCR, Anti-TIF1, etc. Treatment
Treatment for myositis depends on the underlying cause. For myositis that is caused by a viral infection, no treatment is typically needed.