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Updated: Aug 7, 2026
03:37
Cerebral Ischemic Coma Model Induced by Modified Four-Vessel Occlusion
Published on: July 5, 2024
Spontaneous intracranial hypotension resulting in coma: case report
Faisal T Sayer1, Mikael Bodelsson, Elna-Marie Larsson
1Department of Neurosurgery, Lund University Hospital, Lund, Sweden. Faisal.Sayer@neurokir.lu.se
Neurosurgery
|July 11, 2006
Summary
Spontaneous intracranial hypotension, a condition of low cerebrospinal fluid pressure, can lead to coma if misdiagnosed. This case highlights how unwarranted surgery for subdural hematomas resulted in coma, emphasizing accurate diagnosis for this rare illness.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Spontaneous intracranial hypotension (SIH) is a condition characterized by low cerebrospinal fluid (CSF) pressure, often presenting with headaches.
- While coma is a known, albeit rare, presentation of SIH, misdiagnosis can lead to severe complications.
Observation:
- A 62-year-old man with headache was diagnosed with bilateral chronic subdural hematomas.
- Post-surgical deterioration led to profound unconsciousness, with imaging revealing intracranial air and negative intracranial pressure, suggestive of CSF leak.
- Spinal MRI confirmed epidural CSF leaks in the thoracic region.
Findings:
- Misdiagnosis of SIH and subsequent unwarranted surgery precipitated a comatose state in the patient.
- An epidural blood patch provided rapid and significant improvement, restoring consciousness within 24 hours.
Implications:
- This case underscores the critical importance of accurate diagnosis in spontaneous intracranial hypotension.
- It expands the understanding of the clinical spectrum of SIH, particularly concerning iatrogenic complications.
- Highlights the effectiveness of epidural blood patching in managing CSF leak-induced neurological deficits.
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