Volume 45 No 1  Cover Story

Gadolinium-enhanced axial T1-weighted magnetic resonance image (leftt upper) showing intense diffuse pachymeningeal enhancement suggesting intracranial hypotension in a 35-year-old woman presented with a 2-week history of headache, nausea, vomiting, and nuchal pain. The headache is getting severe in the standing position. Computed tomography-myelography shows abnormal contrast extravasation in the psoas muscle (right). Followup MR image (left lower) shows some resolution of meningeal enhancement on the third day after epidural patch of 12 cc of autologous blood.