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Spontaneous intracranial hypotension during pregnancy
1Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-0022, Japan. asakurahirobumi@om.nms.ac.jp
Background:
Spontaneous intracranial hypotension is characterized by postural headache associated with low cerebrospinal fluid pressure.
Case:
A 37-year-old Japanese woman, gravida 3, para 2, had sudden onset of severe postural headache at 8 weeks' gestation, accompanied by nausea and vomiting. Results of medical and neurologic examinations were normal, and there was no measurable cerebrospinal fluid pressure on lumbar puncture. Brain magnetic resonance imaging showed diffuse subdural fluid collection and a narrowing of the ambient cistern, confirming the diagnosis of spontaneous intracranial hypotension. After a month of bed rest and intravenous fluid infusion, all symptoms subsided gradually and did not recur.
Conclusion:
Obstetricians should be aware that spontaneous intracranial hypotension can occur in pregnancy.