Recurrence of spontaneous intracranial hypotension with subdural hematomas

Cephalalgia. 1997 Feb;17(1):42-5. doi: 10.1046/j.1468-2982.1997.1701042.x.

Abstract

A 59-year-old man developed postural headache associated with a low CSF pressure. A CT scan revealed no abnormal findings and the orthostatic symptoms resolved without treatment 6 weeks after onset. He was diagnosed as having spontaneous intracranial hypotension (SIH) and remained symptom-free until he experienced recurrence of postural headache 9 months later. A lumbar puncture demonstrated low CSF pressure, and a CT scan revealed slit-like ventricles with narrowing of the sulci, Sylvian fissures, and infratentorial cisterns, in addition to bilateral subdural masses. After draining the hematomas, his symptoms resolved completely, and a follow-up CT scan was normal. We hypothesize that recurrent SIH in this case was due to small recurrent tears of a root sleeve. This case emphasizes the importance of follow-up of SIH for at least 9 months after resolution of symptoms.

Publication types

  • Case Reports

MeSH terms

  • Brain / diagnostic imaging
  • Headache / diagnostic imaging
  • Headache / etiology*
  • Hematoma, Subdural / diagnosis
  • Hematoma, Subdural / physiopathology*
  • Humans
  • Hypotension
  • Intracranial Pressure*
  • Male
  • Middle Aged
  • Recurrence
  • Tomography, X-Ray Computed