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Spontaneous intracranial hypotension: case series of rare clinical presentations.
MedLine Citation:
PMID:  21156430     Owner:  NLM     Status:  In-Data-Review    
Background: Spontaneous intracranial hypotension (SIH) is an increasingly described entity, with over 70 cases reported in the literature. The classic triad includes orthostatic headache, diffuse pachymeningeal enhancement on magnetic resonance imaging (MRI) with gadolinium, and low cerebrospinal fluid pressure (CSF) in the lateral decubitus (<60 mm H2O) and sitting positions. Method: We present four rare clinical presentations of SIH, two of which have not been previously described in the literature, to the best of our knowledge. Results: Patient 1 presented with dyspnea, dysphagia, bilateral ptosis, diplopia and seizures. Patient 2 presented with a paradoxical positional pattern of orthostatic hypotension. In Patient 3, bilateral subdural hematomas (SDH) were encountered; while in Patient 4, a recurrent unilateral SDH requiring multiple surgical interventions was demonstrated. Conclusion: Although uncommon clinical presentations, all four cases of intracranial hypotension were spontaneous, demonstrated diagnostic MRI findings, and responded favorably to blood patches or saline injections.
N Chaudhary; P Cooper; S P Lownie; W Ng; N Duggal
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques     Volume:  38     ISSN:  0317-1671     ISO Abbreviation:  Can J Neurol Sci     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0415227     Medline TA:  Can J Neurol Sci     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  54-8     Citation Subset:  IM    
Division of Neurosurgery, London Health Sciences Center, London, Ontario, Canada Clinical Neurological Sciences, London Health Sciences Center, London, Ontario, Canada.
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