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Chronic intracranial hypotension.

R A Mackenzie1, A K Lethlean, R Shnier

  • 1Institute of Neurological Sciences, Prince of Wales Hospital, High Street, Randwick, NSW 2031, Australia.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|July 22, 2008
PubMed
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A 49-year-old male experienced chronic headaches due to a cerebrospinal fluid (CSF) leak from a thoracic arachnoid cyst. Surgical repair resolved his headaches and other symptoms, suggesting a long-term effect of the initial injury.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Intracranial hypotension can result from cerebrospinal fluid (CSF) leakage.
  • While often self-limiting, some CSF leaks require surgical intervention.
  • Chronic intracranial hypotension may arise from inadequately sealed defects.

Purpose of the Study:

  • To report a case of chronic intracranial hypotension caused by a leaking thoracic extradural arachnoid cyst.
  • To highlight the potential for delayed symptom onset and resolution following surgical repair.

Main Methods:

  • Case report of a 49-year-old male with a 10-month history of headache.
  • Diagnosis of a leaking thoracic extradural arachnoid cyst.
  • Surgical repair of the arachnoid cyst.

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Main Results:

  • Successful surgical repair of the thoracic extradural arachnoid cyst.
  • Complete resolution of recent headaches and chronic alcohol-related headaches.
  • Improvement in long-standing anemia and tinnitus hyperacusis.

Conclusions:

  • A thoracic extradural arachnoid cyst can cause chronic intracranial hypotension and diverse symptoms.
  • Surgical repair can effectively treat symptoms of chronic intracranial hypotension.
  • A remote injury may initiate a CSF leak leading to long-term complications.