SynthesisThe journal of headache and pain2026
Temporal and regional trends in the diagnosis and treatment of spontaneous intracranial hypotension: a systematic review.
Synthesis in The journal of headache and pain, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundSpontaneous intracranial hypotension (SIH) is an underrecognized condition with rapidly evolving diagnostic and therapeutic strategies. This study investigated temporal and regional trends in diagnostic and therapeutic modalities for SIH in the published literature.
methodsWe systematically reviewed SIH-related clinical studies in PubMed from inception through December 2024. Data on study site (continent/country/institute) and diagnostic and treatment modalities used in clinical settings were extracted. To assess temporal and regional trends, the reported use of each modality was analyzed over 5-year intervals and across regions, separately for case reports and original articles, which respectively reflect real-world and research settings.
resultsA total of 789 articles (529 case reports and 260 original articles) were included. In case reports, brain MRI (84.4%), lumbar puncture (84.4%), and RI cisternography (50%) were the most frequently used diagnostics in 1990–1999, while brain MRI (91.1%) and spine MRI (74.8%) became predominant in 2020–2024. The use of lumbar puncture and RI cisternography declined to 24.4% and 5.9%, respectively, while dynamic CT myelography (18.5%) and digital subtraction myelography (23.7%) became more common in 2020–2024. Conservative management (81.3%) was the most common treatment in 1990–1999, while surgical repair increased to 39.8% in 2020–2024. Similar trends were observed in original articles. These temporal trends were similar across regions; however, in 2020–2024, dynamic CT myelography, DSM, and surgical repair were reported more frequently in publications from North America and Europe than in those from Asia (dynamic CT myelography: 35.4% and 22.0% vs. 4.7%; DSM: 40.8% and 33.0% vs. 6.7%; surgical repair: 59.3% and 42.5% vs. 13.6%).
conclusionsDiagnostic and therapeutic modalities for SIH have markedly shifted over time, reflecting the actual changes both in real-world practice and academic settings. Standardized diagnostic and treatment guidelines and broader global awareness of evolving practice are warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.